Is this nerve damage after my cheek filler?

I'm sorry to hear about your experience. Your description of top lip ptosis/paralysis following the removal of permanent cheek filler using an ultralesional optic fiber laser raises several important points that need to be addressed by a healthcare professional. Here are some considerations and steps you should take:

1. **Nerve Damage Possibility**: The symptoms you describe, such as difficulty smiling, talking, and using a straw, suggest that there may be nerve involvement. The facial nerve, which controls the muscles of facial expression, could potentially be affected by trauma, compression, or heat damage from the laser treatment.

2. **Duration of Symptoms**: The fact that your symptoms have persisted for 6 months without improvement is concerning. While some nerve injuries can take time to heal, persistent symptoms over such a period warrant further investigation.

3. **Consultation with Specialists**:
- **Neurologist**: A neurologist can perform a detailed assessment of your facial nerve function and may recommend imaging studies (such as MRI or nerve conduction studies) to evaluate the extent and nature of any nerve damage.
- **Plastic Surgeon or Facial Specialist**: Consulting a plastic surgeon or a specialist in facial nerve injuries can provide additional insights. They can evaluate the structural and functional aspects of your face and might offer treatment options.

4. **Possible Interventions**:
- **Physical Therapy**: Sometimes, physical therapy can help in the rehabilitation of facial muscles and nerves.
- **Medications**: Depending on the findings, certain medications might be prescribed to support nerve health or manage symptoms.
- **Surgical Options**: In some cases, surgical intervention might be considered to repair damaged nerves, though this depends on the specific nature and location of the injury.

5. **Documentation and Follow-up**: Keep detailed records of your symptoms, treatments, and consultations. This documentation can be crucial for ongoing care and any potential legal considerations.

6. **Seek a Second Opinion**: Given the complexity and severity of your symptoms, seeking a second opinion from another qualified specialist can provide additional perspectives and treatment options.

It's essential to address this issue promptly to explore all potential treatment avenues and support your recovery. Please ensure you follow up with a healthcare professional as soon as possible.