I had a Mid face / Neck lift 14 weeks ago. My mouth is now crooked. Any suggestions? (photos)

I think I might have either a cut Mandibular nerve or a damaged one,as I cannot smile, It is hard to eat on the left side, its almost like its paralysed ,I also cannot get words out when I'm excited or try to talk too fast. I cannot go back to see my surgeon, as I foolishly went to Thailand, I have numbness around the front of the ears and the left and very numb under my right chin, more so than the left side, I have not felt any signs of tingling to reassure me that the feeling is coming back

Doctor Answers 4

Marginal mandibular injury

I agree with my colleagues, that often the nerve is injured, rather than cut, and can heal over months.  If you want to know for certain that the nerve is anatomically intact, consider a consultation with a neurologist and an EMG.  Sometimes the facial asymmetry can be treated with the judicious use of botox on the other side to produce symmetry while the injury heals.  Best of luck with your ongoing recovery.

Fairfax Plastic Surgeon
4.7 out of 5 stars 48 reviews


You have a weakness of your marginal mandibular nerve from your neck procedure. In many cases, this weakness recovers if you give it enough time. You need to wait a minimum of 6 months for recovery.  Sometimes it can take longer. It's best to be patient.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 22 reviews

Mouth crooked from facelift

depending on what techniques were done, there certainly could be some marginal mandibular weakness (at the very least) resulting from your surgery.  It can take 6 months to a full year for that nerve to regain its strength if it was just weakened during surgery from some manipulation.  At this time, the best thing to do unfortunately is give it time.  You are only 14 weeks out and you may be surprised as there may be some improvement over the coming months.  Keep an eye on it and hang in there!

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Mouth crooked after mid face/neck lift

From the photos you provided, it does appear that there may be some weakness to your marginal mandibular nerve on one side.  It is impossible to know if this is a permanent injury or just temporary, but it can take 6 months or more in some cases for a temporary injury to resolve.  Since your surgery was 14 weeks ago, I would wait a bit more time to see if things improve.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.