This was really severe when the surgery was first over. It gets even worse if I'm crying. Three days ago, I started massaging my chin based on a post that I read. If I massage the area, then my lip involuntarily pulls downward without me doing anything. I also still have some numbness in my neck, but it's getting better. I have mild Type II diabetes. I just want my big smile back. Why is this taking so long to heal? What can I do to find out if my damage is permanent?
Answer: Marginal mandibular nerve injury Liposuction involves sculpting fat with suction connected to a narrow tube with side holes at the end. The fat gets pulled into tube and out of the area. The marginal mandibular nerve is a motor nerve that courses just below the jaw to the depressor muscle of the mouth. This muscle pro pulls down the mouth in frowning. The liposuction process can injure the nerve but typically does not sever it completely. You noted that the lip moves with massage of the area which is a good sign of nerve healing. Time will tell whether you have any permanent injury and it may take several months to get there.In the meantime you can ask your plastic surgeon to do some Botox injections into the other depressor oris muscle. This will provide some symmetry until the damage side is healed.All my best.
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Answer: Marginal mandibular nerve injury Liposuction involves sculpting fat with suction connected to a narrow tube with side holes at the end. The fat gets pulled into tube and out of the area. The marginal mandibular nerve is a motor nerve that courses just below the jaw to the depressor muscle of the mouth. This muscle pro pulls down the mouth in frowning. The liposuction process can injure the nerve but typically does not sever it completely. You noted that the lip moves with massage of the area which is a good sign of nerve healing. Time will tell whether you have any permanent injury and it may take several months to get there.In the meantime you can ask your plastic surgeon to do some Botox injections into the other depressor oris muscle. This will provide some symmetry until the damage side is healed.All my best.
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December 27, 2015
Answer: Abnormal Smile After Liposuction This can happen with aggressive liposuction to the neck/jawline. It is best if you are still experiencing difficulty smiling weeks after surgery to get on oral steroids and diuretics as well as nonsteroidal antiinflammatories. I also would start you on neurontin. These combine to decrease the swelling and inflammation on the nerve. Venus legacy treatments have helped in my practice, for patients referred to me. Over time the nerve should calm down but if it doesn't you should see a nerve specialist. Best, Dr. Emer.
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December 27, 2015
Answer: Abnormal Smile After Liposuction This can happen with aggressive liposuction to the neck/jawline. It is best if you are still experiencing difficulty smiling weeks after surgery to get on oral steroids and diuretics as well as nonsteroidal antiinflammatories. I also would start you on neurontin. These combine to decrease the swelling and inflammation on the nerve. Venus legacy treatments have helped in my practice, for patients referred to me. Over time the nerve should calm down but if it doesn't you should see a nerve specialist. Best, Dr. Emer.
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December 25, 2015
Answer: Lip Weakness Following Liposuction Thank you for your question and hopefully we can assist you in understanding what to expect following your procedure with your doctor.Liposuction removes fatty tissue from the layer between the skin and muscle. The marginal mandibular nerve runs beneath the muscle and passes close to where your liposuction procedure was performed. Although I have not seen this in my practice, the nerve can become bruised or traumatized from adjacent liposuction and lead to a temporary weakness in lower lip depression. This is why when you smile, your lip on one side does not lower normally. It generally takes a few months at a minimum for the nerve to recover. It almost always does, so do not worry too much. Consider asking your plastic surgeon to place a little botox beneath the lip on the other side so that your lips move symmetrically while your lip depression nerve recovers. That will help!Best wishes!
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December 25, 2015
Answer: Lip Weakness Following Liposuction Thank you for your question and hopefully we can assist you in understanding what to expect following your procedure with your doctor.Liposuction removes fatty tissue from the layer between the skin and muscle. The marginal mandibular nerve runs beneath the muscle and passes close to where your liposuction procedure was performed. Although I have not seen this in my practice, the nerve can become bruised or traumatized from adjacent liposuction and lead to a temporary weakness in lower lip depression. This is why when you smile, your lip on one side does not lower normally. It generally takes a few months at a minimum for the nerve to recover. It almost always does, so do not worry too much. Consider asking your plastic surgeon to place a little botox beneath the lip on the other side so that your lips move symmetrically while your lip depression nerve recovers. That will help!Best wishes!
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December 25, 2015
Answer: Why's my recovery taking so long Thank you for your question and series of photographs. I am sorry to hear of your issues after neck liposuction. Liposuction cannulas are designed with a blunt tip so that as it moves through the adipose tissue of our body it spreads and pushes the more important arteries, veins, and nerves out of the way. Assuming you had traditional tumescent liposuction any injury to the nerve was most likely a bruise which should return in time, normally 6-8 weeks, but occasionally longer. If a different type of liposuction was performed, more nerve injury may have occurred and your recovery should be followed along closely. Hang in there and keep in close contact with your surgeon.
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December 25, 2015
Answer: Why's my recovery taking so long Thank you for your question and series of photographs. I am sorry to hear of your issues after neck liposuction. Liposuction cannulas are designed with a blunt tip so that as it moves through the adipose tissue of our body it spreads and pushes the more important arteries, veins, and nerves out of the way. Assuming you had traditional tumescent liposuction any injury to the nerve was most likely a bruise which should return in time, normally 6-8 weeks, but occasionally longer. If a different type of liposuction was performed, more nerve injury may have occurred and your recovery should be followed along closely. Hang in there and keep in close contact with your surgeon.
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December 25, 2015
Answer: Marginal Mandibular Nerve Palsy Thank you very much for your question.If this was just liposuction, then the nerve is likely just "contused" and not cut, and the function will come back with time (exactly how long isn't known, but it could take up to 6 months or even longer). If there was energy used such as laser or ultrasound, there may be more damage to the nerve and it could take longer (or be permanent, but this is VERY rare). I don't know who posted about massage (if it was a doctor or a patient), but in general I do not recommend massage for this purpose.I would follow with your doctor closely, but it's just a waiting game at this point. Again, the odds are greatly in your favor that you will have return of function, we just can't say when.Best of luck!
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December 25, 2015
Answer: Marginal Mandibular Nerve Palsy Thank you very much for your question.If this was just liposuction, then the nerve is likely just "contused" and not cut, and the function will come back with time (exactly how long isn't known, but it could take up to 6 months or even longer). If there was energy used such as laser or ultrasound, there may be more damage to the nerve and it could take longer (or be permanent, but this is VERY rare). I don't know who posted about massage (if it was a doctor or a patient), but in general I do not recommend massage for this purpose.I would follow with your doctor closely, but it's just a waiting game at this point. Again, the odds are greatly in your favor that you will have return of function, we just can't say when.Best of luck!
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