This 35-year-old female patient suffered from severe synkinesia after defect healing of the facial nerve in the right side of her face. She complained of uncontrollable eye closure when smiling, marked and sometimes painful spasms of the midface, mouth region, and neck. Analysis revealed uncoordinated muscle activity at the corner of the mouth. A so-called negative vector (corner of the mouth on the right side points downwards despite smiling) can be seen. After a targeted removal of several nerve branches (selctive neurolysis, selective neurectomy) and a muscle transposition as well as partial removal (all in one operation) via a facelift incision, the face appears much more balanced. The lady is able to smile more symmetrically, the eye remains open, the painful muscle tensions have been further relieved, and the annoying retractions in the chin area have also been reduced. Consistent exercise therapy is now indicated to further improve the surgical result. The patient's quality of life has already improved massively.