Upper lip paralysed after facelift and necklift 2 weeks ago. Is this permanent? (Photo)

Sorry for your troubles after your facelift. Temporary facial nerve branch weakness is uncommon, and permanent paralysis is extremely rare. It is a known risk of the procedure that I include in all my consultations, even though it is not anything I have heard of in the community I practice in. It seems that you have a fairly substantial weakness. I was a head and neck surgeon before I became a plastic surgeon and I worked around the facial nerve a lot during cancer operations. If there was any post-operative weakness, I would tell patients that if there was any movement at all, there was a very good chance that function would return. Some surgeons recommend oral steroids to reduce swelling around the nerve. This has been associated with better outcomes. If there was a known injury to the nerve, it can be repaired in the early postoperative period. I would revisit the situation with your facelift surgeon.

Hello,Yes, this is typically a temporary thing. I have never seen that type of paralysis persist and it is common to ask a patient to smile after a facelift to see if there is a temporary paralysis. It can sometimes take 3 months for this to resolve but it should resolve. All the best,Dr. BlaggAustin, TX

The good news is that this sort of issue almost always resolves spontaneously.  There is some sort of inflammation or injury affecting the buccal branch(es) of the facial nerve. This particular part of the facial nerve has the most arborization (branches) and almost always returns to normal.  I advise patience and maintenance of a good relationship with your Surgeon, who is likely to be your biggest ally for purposes of reassurance. 

Injury to the buccal nerve can improve with time as the nerve injury heals and regenerates.  Also, there are significant collateral branches that can make up for injuries of some of the branches.  You should be patient for about 3 months and you should see significant improvement if not complete resolution. 

This is a known but rare risk of facelift surgery.  This should have been reviewed with you during the consent process before surgery.   The vast majority of these types of injury are from traction or cautery rather than transection of the nerve.  Therefore when patients develop  facial nerve weakness after facelift surgery the vast majority notice full recovery within weeks.   It sounds like your surgeon is aware of the situation and is best equipped to follow you through the healing process.