Are Pulling & Tightness Around Ears After Facelift Always Indicative of Nerve Damage?

The sensations you are describing are attributable to recovery of sensory nerves, known as paresthesias.  This is a totally normal process after a facelift.  The improvement in symptoms should continue over the next few months.

The sensations you are feeling are due to scar tissue and 'tissue remodeling', which means the underlying scar and skin tissue under the areas of skin that were 'lifted' are healing after the procedure. Usually these sensations resolve soon after the procedure, however can take longer. Since they are reducing in frequency, they will continue to do so and should resolve completely. It can take up to 6m for the sensory nerves to return to normal around the ear. Hang in there and discuss your concerns with your plastic surgeon. Gentle massage to the area can also help with the 'tight' feeling.

It does not sound like you have any serious nerve damage after your procedure. In general, regarding sensation, we worry about the great auricular nerve which if damaged would result in numbness of the majority of the ear. The pulling and tightness feeling can take a long time to resolve, and it seems like with time, it should get completely better for you.

-Dr. Jamil Asaria

FACE Toronto

  The sensation of tightness should improve over the course of a year as the scars soften.  Massage can help those areas. This is not indicative of nerve damage but the scarring process.

Very sorry to hear about the uncomfortable side effects you are experiencing. It is not uncommon for any temporary nerve damage following a facelift to last 6 months to a year. In some cases, it may even last longer. If temporary nerve damage has taken place, you may feel numbness around your ears, numbness on other areas of your face, and drooping of your mouth and/or cheek. The fact that the sensations are reducing in frequency is a good sign, and they should continue to improve over time. A good way to relieve any tightness that is present (which is also normal given your post-operative time period) is with light massage. But I would only do this if you can tolerate it. I would recommend speaking with your physician for details, as he/she will be able to provide you with additional insight given your circumstances. Thank you, and best of luck with the remainder of your recovery!

Hi!

Thank you for your question,

Tightness and numbness it typical for this procedure. I would not
worry as it may take up to six months to a year for these sensations to subside. If

you are still worried, I would recommend a follow up with your board
certified plastic surgeon for peace of mind.

Good luck.

Dr. Sam Speron

The tightness that you are experiencing is typical of the healing process.  This should continue to improve with time.  Please revisit with your plastic surgeon.  Nerve injury is unlikely.

Dr. ES

Dear PLM11,


Nerve damage happens when you cannot move your face like you did before

Overall it sounds like you are getting better

So in short, it does not sound like you suffered nerve damage

The tightness will get better over time, it just comes from pulling the muscle up

You may want to talk to your surgeon to see if massaging the areas are appropriate (check with him/her first)


Best regards,

Nima Shemirani

By 5 months after facelift your healing is significantly down the road to completion, but complete scar maturation can take 6-12 months, and maximum sensory nerve regeneration can take up to a year or more, and may not completely return to "pre-op normal." Your own comment that 80% of the numbness is gone is right on target, and can be expected to continue to improve a bit more over the next few months.

As far as tightness and pulling are concerned, this too should improve, but you do have scar tissue, healing sensory nerves, and none of this "goes away" but becomes less noticeable and bothersome as you develop into a "new normal."

Sometimes tightness and pulling are technique-related, and skin-skin facelifts (or what I call "hanging the cheek skin from the earlobes") without deep suture fixation to the temporal and mastoid fascia can give not only a tight, pulled look ("pixie earlobes") but also the sensations you describe. Securing the deeper tissues with soft permanent sutures  (SMAS plication or fixation, and platysma plication or suspension) to the temporal and mastoid fascia can help increase longevity of the result, decrease tension on the skin incision (better, less-visible scar), reduce the tight, pulled sensation as you heal, and prevent the "pixie ear" deformity!

But only if it's done properly!

If you look great, have hidden incision placement, minimally-visible scars, and no distortion of your earlobes, then good for you (and your surgeon). The rest should continue to improve.

If any of the above are not being seen, then you may be a candidate for revision to improve these factors, but not for an additional several months until you have reached you new baseline and an appropriate plan developed.

Fortunately, the former scenario is the most likely, so be patient with yourself and be glad you look great. If not, this can be improved in most cases. Best wishes! Dr. Tholen

Pulling and tightness around the ears after a facelift are not indicative of nerve damage.  There is still healing occurring at five months after the procedure, and as you have seen, there are still changes taking place.  The pulling and tightness feeling that you are having should improve over more time.