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The face is responsible for nonverbal communication. Facial nerve paralysis, which is the weakness or paralysis of the nerve responsible for the innervation of the muscles that perform these movements, is a condition that can raise serious physical, psychological, social, professional, aesthetic, and functional disorders. The physical aspect has a disastrous effect on the patient's self-image and emotional state. This study aimed to evaluate the self-image of patients with facial paralysis through the Body Image Quality Life Index (BIQLI), pre- and postclinical treatment with botulinum toxin.A prospective, exploratory, comparative cohort was carried out, with quantitative analysis of the variables with 40 patients with facial paralysis treated by the Ambulatory of Plastic Surgery of Hospital das Clínicas, Faculty of Medicine, University of São Paulo. The Sociodemographic and clinical instrument and the BIQLI were applied. Descriptive statistics and statistical inference were used to perform the analyses.It was found that the majority of the paralysis occurred in female individuals (55%), with an average age of 47,875 (DP), single and married (38.88%), and with secondary education completed (16.66%).The body image evaluation of patients with facial paralysis submitted to the botulinum toxin treatment showed an ability to identify the positive impact of therapy in the period between 15 and 180 days by the BIQLI.