6 Weeks Post Facelift: Right Side Palsy - What Can I Do?

I'm sorry to hear about your diffuclties recovering from a facelift.  It is not uncommon to have temporary facial nerve injury following a facelift; in fact, this happens in about 1% of patients. 

Fortunately for you, facial nerve palsy and facial muscle weakness following a facelift is almost always temporary, with full recovery by 3-6 months.  The injury to the facial nerve is usually secondary to stretching or bruising and is unlikely to require futher surgery for repair.

The symptoms you are having, such as asymmetric smile, tearing, and difficulty blinking, are not surprising given the injury.  If the asymmetry really bothers you, you could ask your plastic surgeon to give you a little botox on the left side of your face.  This will temporarily weaken a few of the facial muscle on the left side of your face, making you a little more symmetric while the right facial nerve recovers.

The most important thing you can do, however, is to be patient and follow up routinely with your plastic surgeon.

Jaime Perez, M.D.

Face Lift Specialist in Tampa, Florida

Plastic Surgery Center of Tampa, Florida

Although it is hard to tell without seeing your pictures what you are describing is likely going to improve over months (6-12).  In the meantime there are measures to help you with your eye tearing that your surgeon can discuss with you

 At 6 weeks, your nerve may be bruised. You may want to get another opinion from a Board Certified Plastic Surgeon to evaluate your face and provide you with another opinion.  Too many opinions can be a problem so avoid that pitfall.  Stay in touch with your surgeon and ask for more information on the progress thus far.

  You have already gotten wonderful (free) advice on this forum.  I would like to add that while the eye is not closing or blinking properly, I recommend that you make certain that you are keeping it well lubricated with artificial tears and ointments.  IMHO, I am not sure that you even need another opinion.  Your doctor is right in that it almost (not 100%) will improve with 6-12 months of healing.

I'm sure this is a very trying and frightening time for you.  Facial Nerve Injuries during facelift surgery is very unusual and most likely this is a temporary injury.  The most important function of the facial nerve is to protect the eyes.  Consider seeing an opthalmologist to maintain the integrity of your cornea to minimize any visual problems.  Nerves can recover as soon as 4 weeks or can take as long as several months.  The most important thing is to remain optimistic and hopeful.  Good luck.

The question describes as facial nerve palsy after a mid face lift.  The incidence of neuropraxia is higher in a subsperiosteal mid-face lift than it is for a SMAS based Facelift (jawline, neck).  The good news is that the majority of neurporaxias resolve spontaneously; 45 days is still well within the window where recovery is possible.  The biggest concern you have right now is inability to close your eye.  I would use artificial tears (Refresh, systane) liberally, apply a thicker form of ointment at night (Refresh PM, lacrilube), and even tape the eye shut while sleeping until function recovers.