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Does Ear Lobe Numbness After Mini-lift Always Indicate Permanent Damage to Greater Auricular Nerve?

Both earlobes and surrounding skin are numb 10 weeks after mini-facelift. My board certified ps says sensation likely will return. Information on this site is conflicting as to whether ear lobe numbness indicates permanent damage or not. What is your opinion? Are there any definitive tests a neurologist can perform? Thanks so much for your time.

Doctor Answers (9)

Does earlobe numbness after mini-lift always indicate permanent dame to Great Auricular Nerve?

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Hello! Thank you for your question! Numbness after any surgical procedure is expected for several weeks to months following. As the nerves to the area are traumatized and will then experience a temporary neuropraxia, a transient loss of nerve conduction. This usually resolves over the next 6-12 weeks, but depending on the procedure performed, sometimes much longer. Typically this should resolve by 1 year. As it goes past this date, the likelihood of the sensation returning is small. However, it can take up to 2 years. If no return from there, it is unlikely to return. It should be discussed that persistent sensory changes may develop following any surgical procedure.  That nerve is the most common - however, it is usually just neuropraxia with the sensation returning over weeks to months.  Only time will tell - but followup closely with your surgeon.

The usual signs of the nerves regenerating and neuropraxia resolving is itching, followed by a burning sensation and then occasional sharp, shock-like pains. These will be normal to experience, and actually a promising sign. Usually, normal sensation returns, but is is also possible to have decreased sensation or even increased sensation to the areas affected. Re-educating nerves postoperatively is often helpful and will allow proper instruction for the affected sensory nerves - methods include using different textures to the affected areas when showering, bathing, applying lotion, etc. If bothersome, there are some medications that may be helpful, including Neurontin for pain for hypersensitivity. You can try various textures such as washcloths, loofahs, cotton sheets, etc. Massaging the areas is also beneficial for the incision to make the finest scar possible. The last place to regain the sensation will be directly adjacent to the incision/scar as the nerves will make its way from the periphery to this location. If continual pain arises, evaluation is warranted. After ruling out other causes, one rare explanation may be that a neuroma has developed and may require surgical excision. This is very unlikely unless a large sensory nerve has been transected inadvertently during the procedure. Hope that this helps! Best wishes!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Damage to the Greater Auricular Nerve After Mini-facelift

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It will always be the case that mini-facelift incisions will cut the earlobe free so it not distorted when the facial skin is pulled back and resected. The earlobe will stay numb for weeks without an injury to the GAN. In my experience, even if the nerve is accidentally transected there may or may not be permanent numbness. There is no diagnostic test that reveals a cut nerve. Intervention may be necessary if a "neuroma" occurs at the site of the transection causing shooting pain to the ear. At 10 weeks postop some ear numbness is to be expected and the ear sensation should return to normal.

Paul S. Howard, MD
Birmingham Plastic Surgeon
5.0 out of 5 stars 7 reviews

Numbness of Earlobes 10 Weeks after Facelift

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   Numbness of earlobes is usually temporary and will resolve in a few months.  Permanent numbness is more unusual.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 210 reviews

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Numbness and Nerve Injury

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The thing to realize about the healing process from facial surgery is that the nerves of sensation are the SLOWEST to heal. Skin, muscle and blood vessels all heal fairly quickly (usually within 6 weeks), but all patients will continue to note numbness and differences in the sensation in the skin for much longer. The great news is that sensory nerves (the ones in charge of feeling on the skin) are almost always good at healing, eventually with time. Whether from a browlift, hair transplant, facelift or other procedure, it can easily take 3-6 months for a normal level of feeling to return in the area covered by a specific sensory nerve.

Manu Gujrati, MD
San Jose Facial Plastic Surgeon

Ear Lobe Numbness 10 Weeks after Mini Facelift

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It is normal to have ear lobe numbness following facelift surgery and should resolve in the future. Permanent numbness is very rare. Be patient.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
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Earlobe Numbness After a Facelift Almost Never Indicates Damage To The Greater Auricular Nerve

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If it is primarily ear lobe and surrounding skin numbness that is the issue then you didn't have an injury to the greater auricular nerve. A greater auricular nerve injury causes a dense numbness to the entire ear and the skin surrounding it (cheek in front of the ear and the skin behind the ear). The incision made around the earlobe during a mini lift cuts through the tiny nerve fibers running through the skin causing the numbness you describe. This is normal and very common. The area of numbness will decrease slowly over a period of months and should resolve completely. It doesn't sound like you have anything to worry about (if you did have an injury to the greater auricular nerve, the area of numbness will get much smaller over time, there is nothing to be done for it now anyway,  and therefore there is no reason to do any diagnostic tests). Good luck.

Michael R. Menachof, MD, FACS
Denver Facial Plastic Surgeon
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Ear numbness after facelift

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This is very common after a facelift and is usually due to the skin dissection and removal around the ear. As long as the numbness is improving, it will get better and can eke up to 6m to get 100% better. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
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Ear Lobe numbness

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It sounds very unlikely that both nerves, left and right sides, were damaged.I would also expect other symptoms besides numbness. I would wait and see if sensation starts getting better. Although you are 10 wks from surgery, your surgeon may consider prescribing an anti-inflammatory medication.

Best,

Michel Siegel, MD
Houston Facial Plastic Surgeon
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Numb earlobes post facelift

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Injury to the Great Auricular Nerve unfortunately is occasionally seen post facelift. This may be due to bruising or transection (cutting) of the nerve. If the nerve has been bruised, it may take several months to recover. If was cut, it may never recover. Occasionally, injury to the nerve may be followed by the development of a neuroma (abnormal proliferation of nerve /scar tissue in the area of the injury), and this may require additional treatment by your surgeon or neurologist if painful. There are no definitive tests that could make the diagnosis so soon after surgery - usually time and patience are needed in these situations

Wilfred Brown, MD
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.