Nerve issues 4 years after facelift

Question

I had SMAS facelift 4 years ago and have had hypersensitivity on my upper right cheek and small area near my mouth when anything touches the area. More recently my lower eyelid on that side feels tingly and cold and afollows the nerve to my upper cheek. Anything that touches my upper cheek I feel along my lower eyelid and sometimes the corner of my upper. I feel as my skin is starting to sag that there is tension on the nerves damaged and I am getting more uncomfortable as time goes by.

J. Timothy Katzen, MD, FACS · Answer

Hello. Thank you for your question regarding "nerve injury" four years after a facelift. Any surgical procedure has risks and complications. Nerve injury is a known potential risk with a facelift. Nerve injury can be due to swelling, scar tissue, or even direct injury to the nerve. During the healing phase after a facelift, scar tissue can build up around nerves. The scar tissue can lead to transient, chronic, or even permanent and progressive nerve problems. It sounds like you are having progressive scar tissue developing around the nerves. I would suggest you follow up with your facelift surgeon. It is possible to inject solutions that decrease inflammation and scar tissue. Solutions would be items like 5FU, and steroids. If conservative modalities, like injections, do not work, you may want to consider acupuncture. Another conservative modality is the application of a TENS unit. This helps to electrically stimulate the nerve. Another alternative if conservative measures do not succeed would be a revision facelift to release nerve scar tissue. However, this is invasive and should be saved for a last step. I hope this helps to answer your question regarding "nerve injury" four years after a facelift. Good luck.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Zoran Potparic, MD · Answer

In most cases, SMAS-based facelifts, even "deep ones" do not require undermining (dissection) in the area below the lower eyelid unless lower blepharoplasty or cheek lift is part of it.  The change of sensation you are referring to seems to be a late effect of infraorbital nerve injury which is located just underneath the lower orbital rim. Traction or dissection in that area during surgery could produce given symptoms. At this stage, only neurolysis of the nerve may create some improvement. In-person, consultation with a board-certified plastic surgeon with experience in microsurgery of nerves is recommended. Good luck.

Nerve issues 4 years after facelift

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Nerve issues 4 years after facelift

Answers (2)

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Everything you need to know about SMAS Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.