My Smile is Crooked 23 Days Post Face and Neck Lift? (photo)

The situation you have is due to temporary trauma to a nerve called the
marginal mandibular nerve. This nerve happens to be superficially located at
the area where the jowls are located in the part of the mandible called the
mandibular notch. This nerve innervates a muscle called the depressor anguli
oris muscle. This muscle, we often refer to as DAO, is the muscle that is responsible
for bringing the corners of the mouth downward, specifically for smiling and
showing the lower teeth, and is part of a complex of muscles in the mouth area.When patients want a procedure to lift the corners of the mouth, I
inject Botox or Dysport into the depressor anguli oris muscle to allow the
outer corners of the lip to go up. This will create a balance between the
depressors and elevator muscles in the mouth area. In your situation, it is most likely swelling that is responsible for your
crooked smile. As swelling gets better, the nerve function will return.
Sometimes the nerve gets traumatized but it doesn’t get permanently injured. The
term for that is neuropraxia which tends to improve over several months.
Initially, it can be a little bit more dramatic but as time goes on, the
function of the muscle tends to come back.
In neurology, people generally wait 3-6 months before they get concerned
about long term permanent injury. I hope that was helpful, I wish you the best
of luck, and thank you for your question.

Sorry to hear about your difficulties after your surgery. This issue with your smile is do to swelling/stretching or damage to a nerve in your face, called The Facial Nerve. Specifically, a nerve called the Marginal Mandibular Nerve. This is a common nerve to get injured during a facelift. Often times, the act of pulling and stretching the tissues causes swelling in the nerve and thus, loss of function can occur. In the vast majority of situations where this happens, you will get full function as the nerve heals. The worst part is, it can be a slow process and patience is required. Hopefully you will start to see some results and improvements over the next few weeks. Dr James Bonaparte

 

On infrequent occasion a patient can experience a somewhat uneven smile after a facelift.  In great majority of patients it resolves spontaneously.  There are different causes for uneven smiles – different nerves, different muscles, differential tissue swelling, etc.  An experienced surgeon can thoroughly assess the cause of asymmetry and make a proper diagnosis.  In this fashion a more accurate time course for recovery can be predicted.  In your particular case, your lower lip weakness can be caused by either marginal mandibular nerve injury, or lack of depressor function of the platysma.  A thorough examination can determine the cause and likely recovery.