Abstract Chronic paralysis of the facial nerve leads to degenerative facial muscle and surrounding soft tissue alterations on the involved side, making the affected patients seem older than their actual age. Moreover, contralateral facial hypertrophy worsens facial asymmetry. Correction of the drooping or wrinkled face due to aging, trauma, or other pathology has been successfully treated with the thread-lifting technique. Here, we present the case report of a 23-year-old female patient suffering from oncologic post-surgery complications associated with chronic facial nerve paralysis. She also suffered from old and new cerebellar syndromes on the right side and lesions of the oculomotor, trochlear, and abducens nerves. Based on the patient history, the condition was treated under local anesthesia by the use of APTOS minimally invasive threads with barbs made from non-absorbable material. Correction and sculpting of the affected cheek area were performed by insertion of a light lift needle, and lifting of the superficial fat pads was secured by subdermal insertion of the light lift thread method. The jowl area was lifted by the superficial insertion of both types of threads. As a result, we significantly improved facial symmetry at rest, a more symmetric smile, a lifted corner of the mouth, and an anatomically sculpted cheek appearance. Introduction Chronic paralysis of nervus facialis leads to degenerative facial muscle alterations on the involved side, thus making the affected patients seem older than their actual age. Moreover, contralateral facial hypertrophy significantly worsens facial asymmetry. In many cases, it may result not only in aesthetic abnormality but also in lowered confidence levels, anxiety, depression, and social isolation [1,2]. The severity of facial paresis appearance depends on the original cause. It can be complete or partial, permanent or temporary [3]. Complete and temporary facial paresis usually occurs after trauma or iatrogenic causes after damaging the facial nerve during parotid gland, temporomandibular joints, and brain surgeries. Unilateral peripheral facial nerve paralysis may have an obvious cause (secondary facial nerve palsy) or may be idiopathic (primary) without a detectable cause (Bell’s palsy). Secondary facial nerve palsy is generally less prevalent than Bell’s palsy (25 vs. 75%) [4]. The facial asymmetry and sagging lead to the inability to smile, and the affected patient constantly has a displeasure facial expression. Moreover, functional impairment can affect eye movement, speech, and the ability to chew food. Chronic facial paralysis is associated with the degeneration of facial muscle fibers, which can cause eyebrow drooping, nasolabial fold flattening, the formation of jowls, and lip volume reduction. As mentioned, morphological alterations are frequently accompanied by hemifacial synkinesis and contractures. Facial skin and soft tissues become loose and saggy, on the affected side, and the malar fat pad alights along the inferomedial direction. Overall, there is a significant volume loss on the affected side of the face [5]. Recently, the surgical treatment of facial paralysis has been divided into two groups: static and dynamic. The first approach is focused on restoring function, and the other one addresses the improvement of facial deformities. However, both approaches require major surgical interventions, both of which are extensively laborious and have insubstantial results [6,7]. A method of thread-lifting has been widely applied to improve a saggy or wrinkled face as a result of the aging process, trauma, or other pathology. As it is a simple and minimally invasive facial reconstruction technique, its popularity has been rising in recent years .