Is Facial Nerve Damage Possible After a Lower Blepharoplasty, with Skin Removal, and Fat Repositioning?

I'm almost 2 weeks post op. Have swelling with hard lump where fat was placed. My lower lid is droopy along with what feels like nerve pain,(hot, sharp) and a funny sensation on left side of my face. I can blink, move my eyes, etc. If it is nerve damage, is this permanent?? I seen my doc last week and I asked him this and he kinda shrugged it off and said the nerve is located further away from my lid. I'm not buying it. Maybe I'm just too nervous of a person and should have never had this done.

Doctor Answers (6)

Swelling and lumpiness following a lower eyelid blepahroplasty

+1

It is unlikely that you would get any permanent injury to the facial nerve from a lower eyelids blepharoplasty however if there was fat repositioning you could get a moderate degree of swelling of the lower eyelid.  Eyelid malposition is another issue to consider.  If you have a lot of swelling the lower eyelid can retract especially if it was loose prior to surgery.  I always pull the lower lid forward at the end of a lower eyelid blepharoplasty and if there is more than 6 mm of vertical distraction of the lower lid then a lid tightening procedure should be performed to prevent corneal exposure and lid malposition.  If you post a photograph we would be able to evaluate the degree of lid retraction if any. 


Atlanta Plastic Surgeon
5.0 out of 5 stars 7 reviews

Facial Nerve Damage After Blepharoplasty

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Though it would be possible to damage nerves during a blepharoplasty surgery, it is highly unlikely that your facial nerve was compromised. You are most likely experiencing swelling, which can make it difficult to move your eyes. I would recommend visiting a doctor who specializes in facial nerve injury to make sure you are healing properly and that there are no other concerns. 

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

The facial nerve is not injured with lower lid blepharoplasty.

+1

The lower lid blepharoplasty will not damage the facial nerve. The muscle might function abnormally for a while because of swelling. Pain in the area is a manifestation of the fifth nerve (trigeminal) not the facial nerve.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 7 reviews

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Facial nerve and blepharoplasty

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Damage to the facial nerve is not likely during a blepharoplasty. The muscles around the eye are innervated from different parts and unlikely to have been affected.  Lower eyelid droop can be from poor support or too much skin removal. 

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Facial nerve question

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It is not facial nerve involvement if you can blink and smile. It is extremely unlikely to hv facial nerve damage after lower eyelids. The skin removal can cause the droopy lid and this should improve over time but without Pre and post op pictures it is difficult to give you more information. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Hard to answer this with the information you have provided.

+1

It actually does not sound like nerve damage that you are describing.  It is certainly possible for lower eyelid surgery to injure the motor nerve for the lower eyelid.  WIth the associated swelling at just 2 weeks out from surgery, it is hard for you to tell if you have a motor injury.  However, lid contour droop does suggest this possibility.  If you are having trouble closing your eyes, the pain may be due to dry eye symptoms.  Generally these get better as you heal.  Your general ophthalmologist can recommend artificial tears to increase eye comfort.  It is not uncommon to have some lumps and bumps after surgery and generally this most often resolve with time.  Consider posting with photographs if your issues persist.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

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.