(1) Background: Accurate knowledge of the dynamic anatomy of facial muscles is crucial for the use of functional and aesthetic botulinum toxin injections. We studied the reliability and relevance of facial painting as a pedagogic tool for the dynamic anatomy of facial muscles. (2) Methods: Different facial expressions were performed by a female model after a professional makeup artist applied makeup to the various facial muscles on her left hemiface. A 3D photograph was taken at the beginning and end of each movement using the VECTRA H2 Imaging System device. Cutaneous movements were visualized using displacement vectors. The correlation between the theoretical and dynamic positions of the makeup–muscle was assessed by two facial anatomy experts, thanks to a correlation scale. (3) Results: The overall average score for the 11 analyzed muscles or muscle groups was 3.36 out of 4, indicating a “strong” to “very strong” estimated correlation. There was a moderate agreement between Evaluator 1 and Evaluator 2 (ICC: 0.64; 95%CI: [0.244; 0.852]; p-value: 0.005). (4) Conclusions: The educational model with facial makeup provides an indirect but nonetheless precise and reliable representation of all facial muscles on the skin’s surface. It is presented as a reliable and reproducible method, which exhibits great potential as a teaching tool.

Background/Objectives: Facial palsy causes both functional and aesthetic impairments, with asymmetry significantly affecting quality of life. Botulinum toxin injections are increasingly used to restore facial balance by reducing contralateral hyperactivity, but outcome assessments remain largely subjective. The objective of this study was to evaluate the ability of three-dimensional (3D) stereophotogrammetry coupled with root mean square (RMS) surface analysis to objectively quantify improvements in facial symmetry following botulinum toxin treatment and to support clinicians in patient care. Methods: Sixteen adults with long-standing unilateral peripheral facial palsy underwent individualized botulinum toxin injections. Three-dimensional images were acquired using the Vectra H2 system before and 2–3 weeks after injection at peak efficacy. Five facial expressions (neutral, surprise, frown, Mona Lisa smile, and forced smile) were analyzed. RMS values were calculated for the whole face and facial thirds. Clinical assessment included House–Brackmann and Sunnybrook scores. Results: Whole-face RMS values decreased significantly after injection (1.51 ± 0.42 vs. 1.35 ± 0.43, p < 0.001). Improvements were observed across all thirds, most notably in the middle third. During expression, symmetry improved for all movements, with the strongest effects for surprise (d = 1.270), Mona Lisa smile (d = 0.870), and frown (d = 0.832). Conclusions: Three-dimensional stereophotogrammetry with RMS analysis provides an objective and reproducible method to quantify changes in facial symmetry after botulinum toxin treatment. This technique may complement clinical scoring systems and support personalized treatment planning in facial palsy patients.