Aims Facial reanimation following radical parotidectomy at our center prioritizes a poly-neural, zone based approach, with concurrent static slings at time of dynamic reinnervation. This study reports quantitative outcomes of midfacial and lower facial symmetry following fascia lata slings, with longitudinal follow-up to five years post-operatively. Methodology A retrospective study of consecutive patients undergoing fascia lata sling suspension between 2018 and 2025 at Chris O’Brien Lifehouse, Sydney, Australia was conducted. Facial symmetry was objectively assessed using the validated Facegram software by two blinded assessors from six weeks to five years postoperatively. Longitudinal changes were analysed using multivariable generalized estimating equation models adjusting for age, sex, radiotherapy, and concurrent dynamic reanimation. Results Forty-four patients were identified for inclusion. At six-week post-operatively, no significant asymmetry was observed in in lip length at repose (p=0.8), nor in the commissural angle (p=0.1) or nasal base height (p=0.09) following technical modification. One patient (2%) developed infection of the midfacial sling requiring debridement (Clavien-Dindo IIIB). Regression analyses showed no significant longitudinal change in lip length (p=0.13), commissural angle (p=0.16), nor nasal base height (p=0.19) asymmetry at repose, including in adjusted multivariable models. Sling placement did not impede masseteric-mediated smile excursion, and was associated with superior commissural angle (p=0.03) and lip length (p<0.001) symmetry on excursion as compared to slings alone. Conclusion Our institutional approach to fascia lata slings offers a robust method of restoring immediate static symmetry, with durable suspension up to five years post-operatively. This stability is maintained in older, irradiated patients undergoing concurrent dynamic nerve transfers, supporting its role in complex oncologic reconstruction for flaccid facial paralysis.