Post-op 18 days for Facelift, unable to pronounce words or smile correctly, pins and needle feeling as well. Is this normal?

I had a facelift, chin inplant, lipo on jowls and fat to lips and cheek. I am almost 3 weeks post op. I am having to really focus on pronunciation of my words, I can't smile.. lips cover my teeth and I'm getting a lot of pins and needle feeling on that jaw side. I called my doctor and he said something about my buccal nerve being irritated. I see him next week but am freaking out.

Doctor Answers 17

Possible nerve issue

Based on your description, it does sound as if you could be experiencing some irritation of the buccal nerve. You've already done what I would recommend which is schedule an appointment to see your surgeon. Thankfully, this is an issue that typically resolves itself in time. 


Kouros Azar

Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Post-op 18 days for Facelift, unable to pronounce words or smile correctly, pins and needle feeling as well. Is this normal?

Your symptoms do sound as though you have had an injury to the buccal branch of the facial nerve as your surgeon explained.  Fortunately, the buccal branch almost always recovers.  Please follow closely with examinations and person by you are doctor.


Thank you for your question. You should remain calm and follow your surgeon's recovery instructions. You should be minimizing the movement of the head and neck, sleeping with your head elevated and avoiding any heavy lifting or straining. These precautions are key for your personal healing process. Please keep in mind that you are very very early in the recovery process and each patient responds to the facelift procedure in a unique way. It may take you another couple of weeks to resume your normal activities. Always consult with a board certified facial plastic surgeon.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 95 reviews

Healing after a facelift.

Dear alicebug,

You had a fairly extensive surgery and it is not unexpected to have continued swelling, discomfort, and muscle weakness at this point. I would assume you have already had 1 or more visits post op with your surgeon, and their explanation of "irritated" nerves should be enough to calm your freak out. It may take several months before you fell as though things are getting back to normal, and while you can potentially slow down progress with smoking or excessive activities, there is likely not much you can do to speed up the natural healing process. If the "pins and needles" are getting worse a topical or oral medication may be of help. It is not an uncommon complaint that patients have when surgery was performed around nerve branches.

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 23 reviews


You had multiple procedures which can lead to a protracted recovery.  With fat grafting, at least 3 weeks is necessary for swelling to resolve so you need to give it time.  Sometimes with just swelling resolution you will find many of your concerns improve.  If a facial nerve was injured, this may take more time to resolve.  Luckily the motor nerves in and around the cheek usually recover due to multiple branches and redundancy. 

Post-op 18 days for Facelift, unable to pronounce words or smile correctly, pins and needle feeling as well. Is this normal?

In the majority of situations such as yours after a facelift nerve function (both sensory and motor) return to normal in the first 6 to 8 weeks.  Hopefully that will be the case for you.  Stay in touch with your surgeon so he can follow your progress and note any subtle improvements as they occur.  Regards

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Needs a check

The buccal nerve will cause the upper lips to not pull up well.
The mandibular nerve will raise the lower lip over the teeth.

Both can be diagnosed on an exam, and time will help them improve as it is still early.

Nerve issue?

Yes, it sounds like you may have irritation or injury to the facial nerve. Often this gets better with time.  Follow closely with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Why would someone not be able to move her lips 3 weeks post facelift?

Thank you Alice for your question.  The surgery you described is a complex one and it is common to have a few weeks for recovery.  Asymmetry is not uncommon shortly after surgery with the bruising and swelling.  Your surgery is performed around nerves and muscles that may be swollen and dysfunctional.  Nerves can be irritated with the surgery and liposuction and it is often temporary (we call it neuropraxia).  It will likely improve.  Keep positive and see your plastic surgeon as planned next week for reassurance.

Kind regards,

Dr. Marc DuPere, Aesthetic Plastic Surgeon

Marc DuPere, MD
Toronto Plastic Surgeon
4.8 out of 5 stars 60 reviews


I would encourage you to stay in close contact with your Doctor. Ask him to get you in to the office earlier so he can see you and provide the information and reassurance young. He should be the best source of accurate information . The internet including this site can often be the source of additional anxiety that you do not need. 

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.