Can I get my smile back after nerve cut or damaged? (Photos)

Thank you for your pictures and questions. It sounds as though you are not even two months out from surgery if I am correct? If that is the case, I would not have expected a full recovery from nerve trauma. The vast majority of nerve injuries from facial cosmetic surgery resolve with time but can take 6-12 months to improve. I would continue to follow with your PS at monthly interval to follow the recovery. Sounds like your surgeon is doing the right thing and seeing a neurologist is likely not going to help anything.Best of luck!

In many cases, the facial nerve will recover with time.  However it may take 6 months or more.  Its best to follow with your plastic surgeon as it will take time.

Hi mary,   Sometimes, one can have nerve damage after a facelift.  In the majority of cases, nerve function will return.  Keep in contact with your surgeon so that he/she can monitor your progress. There is not too much you can do now except to watch and wait. Again, most cases will resolve over time.Best,Dr. Christine Rodgers 

It seems like you have some nerve weakness after your procedure.  This can happen from stretching of the nerves and does not necessarily mean they are damaged.  Continuing to follow up with your plastic surgeon will be important to manage the recovery phase and help speed recovery.  I am not sure that a neurologist would have anything to add at this point.  Your surgeon can also address the lump you are seeing in your neck.

Dear Mary123p:

So sorry for your troubles! Thanks for sharing your photos. It is very helpful.

Most cases of facial weakness following facelift are due to bruising and / or swelling around the nerves to the lower lip, some in the cheek and few to the forehead. The majority will heal and return fully within a year. You should be visualizing return of your lip function at about 6 to 12 weeks and be assured it will function properly. The caveat is that this is also a good time to assess the integrity of the nerve using a EMG / NCS (electromyography and nerve conduction study) to make sure the nerve is not divided; as the sooner the cut nerve is put back together, the faster the recovery.

Please discuss this with your operating surgeon to obtain your best outcome. Generally, it is a neurologist or physiatrist that perform this test.

You may also be helped with exercises, physical therapy and TENS stimulation of the muscles which are weak.

It appears as though your Plastic Surgeon provided an interim benefit for you in using Botox properly to even out the opposite lower lip pull.

I hope this is helpful and you are back to normal soon.

If the nerve was cut, it is unlikely that you will regain function without repair of the nerve. However usually in facelifts the nerve is just bruised / stunned from surgery and should improve with time.

 From the photos  and history presented, it's impossible to tell whether or not the paralysis of the lower lip is directly related to the surgery itself or Botox injections. Best to follow up with your operative surgeon.

mary123p,The return of the symmetry of your smile will depend on if the nerve was just weak or has been injured as a result of the facelift.  Be patient, since it is still early in your recovery.  Be assured that the majority of these post facelift cases return with full function over time.  Best of luck!Dr. Edween

nerve damage or temporary damage is not ideal but a well described consequence of facelift surgery. I think your surgeon is dong the right thing to try and make your smile symmetrical while waiting to check for recovery. Recovery is common but can take up to a year especially in an older patient so please be patient and see what happens. This is by far your best chance of a good outcome. Hope that helps, Adam Goodwin

Hi Mary123p and thank you for your question.
Sorry to hear about your experience. Facial nerve injury is a rare occurrence during facelift (some sources quote 0.53% to 2.6%). The nerve can be stretched or swollen from dissection in which case it will typically recover to full function. Using Botox to the contralateral side can help even out the lower lip while the nerve recovery (which can sometimes take several months) is occurring. A neurologist may be able to do some nerve testing to evaluate the nerve recovery. Based on your pictures, it looks like there is some movement of the lower lip and so recovery may just take additional time.
I would recommend close follow up with your surgeon who can evaluate the area of concern in your neck and can help expectantly manage your lower lip weakness.
Good luck!