I had neck lipo 9 weeks ago & something happened to my marginal mandibular nerve. Why's my recovery taking so long? (Photo)

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.

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.

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!

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.

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!

Be patientthe fact that you already have some improvement is a fantastic signnerves heal VERY slowly but based on what you're reporting - you should continue to improve absolutely stay in close contact with your surgeon and good luck

Although rare, damage to facial nerves can occur with liposuction.  The marginal mandibular nerve is more vulnerable than other nerves because it is located in an area that liposuction is often performed and there are no other nerves nearly to help if it is injured.  The good news is that the vast majority of these injuries simply need time to allow the nerve to regrow its outer layer and return to function.  It can take a bit of time up to a year in some cases.  Continue to follow up regularly with your surgeon to monitor any changes in the area

The nerve that controls our facial muscles is called the Facial nerve, and can be injured in any facial lacerations, trauma, or very rarely cosmetic surgery. Most nerves in our bodies course under muscles and connect on the backside of the muscles, and so are protected from injury, but in the face the Facial nerve does course in the fat over the muscles and can therefore be injured in facial surgery procedures. The good news is that almost 100% of the time the nerve does return to full function, but this can take a long time. The conventional thinking is that 3-6 months is necessary to have the nerve heal and begin to function, and full return to function may be longer. I do not believe that there is any benefit to medications or massage, but please speak to your Plastic Surgeon and they will help guide you on your care. I am sure that this will not be a permanent problem!

If your lip does not come down on the one  side, then you might be experiencing a marginal mandibular nerve injury.  This is often due to a contusion and usually gets better with time. 

Sorry for the complication of marginal mandibular facial nerve branch injury. If you are seeing any starting motion that would indicate recovery is possible. BUT if after 9 weeks there is NO slight visualization of motion than I am concerned this could be permanent. What does your surgeon tell you???