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 18

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.

Denver Plastic Surgeon
4.8 out of 5 stars 24 reviews

Facial expressions after a facelift

Without an exam in person it's hard to tell. With facelift, lipo and chin implant, the muscles and skin around the mouth can be stiff and swollen which may cause your symptoms. If there is a temporary nerve injury during the procedure, your surgeon should be able to see that during the exam. give it time and see your surgeon, these type of symptoms usually get better with time. good luck

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Unable to Pronounce Words, Smile Correctly & Pins and Needle Feeling

When the skin is separated from the underlying tissues during surgery, small sensory #nerves are cut. Varying degrees of numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2-6 months for face, neck and cheeks, and to 9-12 months for the forehead and scalp. Muscle weakness may also be present around the mouth especially if liposuction is used. This typically recovers fully in the months after surgery. As the nerves regenerate, the itching, burning, tingling and shooting #sensations will occur. Ice, moisturizers and gentle #massaging are helpful during this phase of the #healing process. Frequently there is a tight feeling in the neck, jawline and cheek after a facelift. During surgery, not only the skin but the underlying muscles are tightened to create a better and longer lasting result. Additionally, the #swelling will move downward in the first week and the neck will feel even tighter. Do not be alarmed: the sensation will decrease during the first month. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

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

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 35 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 121 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. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 52 reviews

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 31 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.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 19 reviews

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 29 reviews

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.