Will Nerves Reattach After Face Lift?

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. 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!

Patients who undergo facelift
surgery often complain of numbness and skin hypersensitivity. These are normal
findings immediately following surgery, and usually resolve with time. The
hypersensitivity that you describe is known as a dysesthesia. It’s very similar
to what happens when your leg falls asleep. This phenomena occurs when nerves
are compressed, stretched or traumatized.During facelift procedures small
cutaneous nerves are divided and traumatized. In many cases this is made worse
by swelling. When dysesthesias occur patients describe a tingling, burning
sensation that can be very uncomfortable. In many cases, clothing rubbing
against the skin can elicit a burning sensation.These symptoms usually resolve in
six to eight weeks without intervention. In rare cases 12 to 18 months may be
necessary for resolution. In most cases tingling indicates nerve regeneration
is on going. In some cases aggressive massage can desensitize the area and
minimize the pain and discomfort associated with this condition.If you’re concerned about abnormal
sensations following facelift surgery, consultation with your plastic surgeon
is appropriate. Your surgeon should be able to address your concerns and alleviate
your anxiety.

It is fairlycommon for patients to experience temporary numbness on both side of their facefollowing a facelift surgery. During the skin flap elevation and the surgicaldissection some of the small sensory nerves to the skin must be transected inorder to tighten the facial muscle. These nerves will regenerate over timeanywhere between 6 weeks up to a year. In rare cases this numbness and tingling may last up to two years. During my consultation, I discuss thiswith patients, so they know exactly what to expect.

The reason for numbness after a face lift  is that when skin is undermined the microscopic plexus of nerves is divided but in just about all cases reattach over several months up to a year  or more and normal sensation is returned. Tingling is a good sign that they are reattaching and that it is likely your sensation is in the process of returning.  After this period of time may represent an injury to an underlying named sensory nerve. 

Tingling after a facelift one year postoperatively is highly uncommon.  Most likely causes of tingling include the following:


Recovery of sensory nerves- Every patient will have some degree of numbness early on.  The vast majority have this restored within one month to 6 months.  There are some cases which take up to 2 years for this to restore.  Nerve regrowth is variable in every patient.  Some patients swear by homeopathic nerve regrowth remedies.

Hypertrophic scar or keloid- Can give the sensation of tingling.  

Sensory nerves are stretched, pulled, bruised and sometimes cut during a facelift procedure. Nerves re grow very slowly, taking 9-12 months to regenerate and sometimes they do not regenerate at all. Since you are experiencing some tingling, that would mean the nerves are still intact, so you may regain sensation in that area in the future.

It is not common to have tingling in the right side of the face and neck after a facelift. At this point, the nerves will not improve and it most likely a permanent sequela. The tingling in the right side of the face and neck is most likely a result of a cutting or stretching of the greater auricular nerve which innervates the right side of the front part of the ear and the ear itself.

TIngling in the face a year and a half after surgery most likely will not get better on its own. This is most likely a neuroma of some sort whether from a cut sensory nerve or a traumatized nerve.

Most of the nerve recovery after facelift surgery occurs by one year post-op but it is possible that your nerves are still regenerating. Sometimes avoiding caffeine will help to minimize the tingling Supplementing with B-complex vitamins do help support nerve function. You can use sublingual B-12 tablets that you just put under your tongue and let it dissolve. (I have seen this at a great price at Costco). One a day or every other day is plenty. I think they are 2500micrograms.

Nerves do regrow to a certain extent but tingling at one and a half years after a facelift is somewhat unusual, and it's possible that these sensations will not improve on their own.  It can take a long time for things to settle down and heal completely, but tingling is often specifically related to the fine nerves in the area that had surgery.  If it's been like this since the surgery then you cannot necessarily assume that the rate of your progress will suddenly change.  If this is a new symptom you should, of course, address it with your surgeon.

I hope that this helps and good luck,

Dr. E