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. 

Thank you for your pictures and questions. Sorry to hear you are having problems after your procedure. Facial nerve injury is a known but dreaded complication of facelift surgery. However, a permanent nerve injury is usually very rare and the majority of nerve injuries will improve with time, although this can take weeks to months. It sounds as if your surgeon is observant and doing all the right things. Continue to follow closely with him and try to be patient. Best of luck!

I am sorry to hear this happened to you and it is a very upsetting problem.  Facial muscle weakness after facelift is very rare and can involve the lower lip, upper lip/smile or forehead.  In most cases the nerve is just stunned and not actually permanently injured.  There is usually some sign of recovery by 4-6 weeks after surgery and most patients end up fine. 
I would see you PS regularly.  If there is no recovery by 6 months, there are other options to get this fixed.

This is a very rare but recognised complication. In most cases this is a neuropraxia ( a bruising) of the nerve and should improve over a few months and then return to normal. Keep in touch with your plastic surgeon to monitor the situation and for your own reassurance.

I am sorry to hear that you are having this issue. Injury to the branches of the facial nerve is very rare after facelift, but it can happen. The good news is that these types of issues almost always improve on their own over a period of weeks to months. Stay in touch with your surgeon and hang in there. It will get better!

Facial nerve injuries are unfortunate and upsetting to patients.  You are having an understandable response.  He may have wanted you to smile post operatively because his eye caught something about your facial movement after surgery which caused him to test your movement.  Its unlikely because he was suspicious but more likely because he was observant.Facial nerve injuries are rare but are a well established risk of surgery.  Fortunately, the majority of these resolve with time and are not permanent.  Recovery may take months.  Its best to follow with your surgeron and express your concerns, especially about your perception with his attitude about the matter.  He will likely appreciate the feedback and may become more attentive to your situation.