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Chances of Disfigurement from Facelift?

I will have a Facelift to have a cyst removed from near my jaw. How likely is it that a nerve will be touched making my face asymmetric?

Asked 28 months ago by atoric in London
Sort 14 expert answers by:
+2

Chance of disfigurement after facelift

With an experienced facelift surgeon performing a facelift, the chance of a permanent nerve injury is probably around 1% or less. If a small superficial cyst is removed in the process, this risk should not increase. If your doctor is removing a parotid tumor, the chance of a nerve injury is higher, particularly if the tumor is malignant or widespread. The parotid gland has two lobes which are literally separated by the facial nerve, so great skill is involved in removing parotid tumors... more
Brent Moelleken, MD
Beverly Hills Plastic Surgeon
+1

Asymmetry Secondary to Facelift

In experienced hands nerve injury causing facial asymmetry after a facelift is very rare. The risk of nerve injury with cyst removal depends on the location of that cyst on the face and the depth of the lesion. Your surgeon will give you a more specific answer.
Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
+2

Facelift Disfigurement

Question: Chances of disfigurement from Facelift? Answer: There are potential complications and problems associated with any surgical procedure, cosmetic or otherwise. The types of problems and complications pertain to the type of procedure performed. For example, potential problems that may be associated with facelift surgery are different from those associated with gall bladder surgery. True disfigurement from a facelift implies injury to the facial nerve that supplies the facial... more
Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon
+1

Facelift Approach and Cyst Removal

A facelift approach can be used to access tumors of the jaw, parotid and face.  A typical incision to access this is called a Blair incision which goes straight in front of the ear and then along a crease in the neck.  A facelift approach involves an incision behind the tragus of the ear (see attached video) and into the hairline.   In known benign tumors, patients can have a simultaneous lift as well.  This serves two purposes, when a parotid tumor is removed... more
Anil R. Shah, MD
Chicago Facial Plastic Surgeon
+1

Disfigurement from a facelift is exceedingly low

A facelift is not done to remove a cyst from the jawline. A facelift is done for aesthetic enhancement, which is to tighten up the jowls, remove neck fat, tighten up the neck muscles, the facial muscles, and has got nothing to do with a cyst on the face. During the facelift operation in experienced hands, the chance of facial nerve paralysis is exceedingly low. We have never had a permanent facial nerve paralysis in our practice in over twenty years.
William Portuese, MD
Seattle Facial Plastic Surgeon
+1

Higher risk with Parotid gland surgery than with Facelift

Hi Atoric, It really depends on where exactly your cyst is: 1. Parotid gland cyst : if it is here than the risk is higher than with most types of facelift surgery. This is because the facial nerve travels and branches through the parotid gland. In order to remove the cyst, portions of the gland may need to be removed in order to do so. If that is the case then the surgeon will most likely dissect out and identify the facial nerve branches - while this may sound like it puts the nerve at... more
Kamran Jafri, MD
New York Facial Plastic Surgeon
+1

The risk of nerve injury in a facelift is very small

The risk of nerve injury in a facelift is very small; however, having said that I have seen it occur in the hands of many surgeons who do not perform a fair number of these procedures. Typically a facelift is not done to remove a cyst. If it is a parotid tumor near the jaw as it maybe by your description, then the facelift approach is used to remove this type of tumor. However, when you remove a tumor or cyst around or near the facial nerve, the risk of nerve weakness increases to about 10... more
Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
+1

Nerve damage from facial cyst removal

THis sounds quite unusual and most surgeons would not typically perform a facelfit to remove a cyst. They may use a facelift approach to remove parotid tumors which can impinge on the facial nerve. However, in the hands of a skilled surgeon, this should be quite rare. Discuss your fears with your surgeon so that they may provide better counsel.
Otto Joseph Placik, MD
Chicago Plastic Surgeon
+1

Not unusual to approach a neck cyst with a face lift incision but this is not a facelift

Dear Atoric There are a number of reasons that facelifts can cause "disfigurement." Permanent injury to one of the branches of the facial nerve is just one of the causes. However, a cyst along the jaw line is not a medical diagnosis. Cysts can have various causes. A significant concern with these cysts is their relationship to branches of the facial nerve. When these structures are in close proximity, removal of the cyst can cause permanent damage to the motor nerve and long term... more
Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
+1

Facelift or Parotidectomy?

The chance for disfigurement from Facelift (assuming you are seeing a well qualified surgeon) is very small. However, Facelift is a cosmetic procedure and not typically performed to remove cysts. If the cyst is superficial (sebaceous cyst), the chance of disfigurement is very minimal. If the "cyst" is located in the parotid gland, the facial nerve must be identified and dissected out to allow during the procedure to allow for safe removal of the lesion. Exposure of the nerve... more
Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
+1

Nerve injury after facelift

The chance of nerve injury after facelift is very small. You are not having a typical facelift. From the limited information that you provided it sounds like you are having a facelift incision to remove a cyst? Without knowing what this cyst is or where it is located (deep in the facial tissue?), you may have increased risk, but still very small. However, this is all information that you need to discuss carefully with your surgeon. Good luck.
David Shafer, MD
New York Plastic Surgeon
+1

Chances of disfigurement from Facelift to remove cyst near the jaw?

The likelihood of nerve injury with Facelifts is small AND the likelihood that such an uncommon injury should it happen might be permanent and NOT recover is much smaller yet. I ASSUME that the decision to use a Facelift incision to remove a cyst was to spare you a scar on the cheek. That leads me to believe that your "cyst" may actually be a tumor in or associated with your PAROTID gland (the major salivary gland). The vast majority of parotid gland tumors are benign but the... more
Peter A. Aldea, MD
Memphis Plastic Surgeon
+1

Nerve injuries from a facelift should be very rare

 There should be an extremely small risk of permanent nerve injury from a facelift done by an experienced plastic surgeon.  The only thing that concerns me is the cyst you describe.  How deep it is and how involved it is to remove it may increase your risk somewhat.
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
+1

Chances of nerve injury with facelift

Hi, Not knowing anything about the experience and skill of your plastic surgeon makes this question a little difficult to answer. That being said, published rates of facial nerve injury after facelift range between 0.5% to 2.6%. The branch most commonly injured it the marginal mandibular nerve; injury to this can result in an asymmetric smile. Hope this helps. Best of luck.
Sam Jejurikar, MD
Dallas Plastic Surgeon
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