Crooked Smile After Mini Facelift and Chin Lipo

My mom is 8 days post op for mini facelift (lower portion of face) and chin issue is that her smile is crooked right now. Is this permanent?

I am very worried and am hoping this is common and will go away. the dr assured her that he did not cut any nerves. please advise as she is very depressed about it. thank u. She never had a crooked smile before and I cant seem to find much about this. If it is common, how long does it take to go away and is there anything she can do to improve?

Doctor Answers 10

Reassurance is the best medicine for crooked smiles after chin lipo/minilifts.

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Reassurance is the best medicine for your mom after her mini lift/ chin liposuction since it resolves spontaneously in 6-12 weeks on its own in most cases.  Sincerely,

David Hansen,MD

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Uneven smile after Facelift / Neck Liposuction

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The smile is the result of a tug of war between two muscles that pull the corner of the mouth down (depressors) and several that pull the corners up. Sometimes the nerve (marginal mandibular nerve) powering the depressor muscle that pulls the corner of the mouth down is pulled on and as as result the patient has an unopposed, higher smile on the "bad" side. In the vast majority of cases this resolves in a few weeks.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Crooked Smile After Facelift is Usually Temporary

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It can be very hard to handle this issue but tell your mom to hang in there. It keeps getting better every week and usually in six weeks it has improved significantly where other people do not notice it. She will continue to notice it longer as after surgery we tend to keep examining the site of surgery.

What if it is permanent?

In the rare case that it is permanent it can be balanced using botox and in rare cases certain surgeries are able to help a little as well.

What should your mom do?

1. Relax, relax, relax

2. Smile as much as possible and exercise facial muscles by moving lips especially lowe lip in all directions. Muscle activity helps speed the recover.

3. Take one day at a time.

4. Try to get back into her routine as fast as possible to help with emotional recovery.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Crooked Smile after the facelift

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There several reasons why the smile may be asymmenric after the facelift surgery.

Swelling is one of them. Most people have more swelling on one side, than on the other. As the swelling subsides, the smile may even out.

Injury to the marginal mandibular nerve is another reason. Most likely it happens during liposuction. The nerve has been injures but not cut.  It usually recovers in several weeks, and in some patients to recovery it may take 6-9 months.

For now, regardless of the reason for asymmetric smile, nothing needs to be done emergently and time is your best friend. As the swelling subsides and as the nerve starts to recover, the shape of the smile would usually return.


Boris Volshteyn M.D., M.S.

Boris Volshteyn, MD, MS
East Brunswick Plastic Surgeon

Crooked smile after a Facelift

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It is very rare to have permanent weakness from a facelift. The facial nerve controls the movement of the face. The mandibular branch of the facial nerve controls the movement of the lower lip and part of the smile. This nerve is very close to the surface of the skin and can be pushed on during the facelift. This can weaken the nerve causing a temporary paralysis of the smile. This should start to resolve at 2 to 4 weeks after the surgery. It can take 6 months to a year to fully recover but usually recovers much faster than that.

Time is the only remedy.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Crooked smile after face surgery

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This is commonly associated with a nerve "bruise"  (neuropraxia) and commonly returns within 2-3 weeks. Occasionally this can last longer and rarely is it permanent.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Usually temporary

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Sometimes the nerve that controls the lower lip will have a "stretch" injury from the lift and cause a crooked smile. This is almost always temporary but may take weeks to months to resolve. A permanent injury usually only occurs if a nerve is cut, and this is exceedingly rare during a typical mini lift procedure.

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Facial Nerve injury after a Mini Lift / Face Lift

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Temporary nerve weakness after a Mini Lift or Face Lift while rare is one of the more common problems seen after surgery. It happens because the nerve which moves the lip gets pulled and stretched during surgery and as a result smiles can be crooked for a short period of time. In these cases it should be fully resolved by 3 weeks though sometimes can take longer. If needed oral steroids can help move the healing process along.

Even rarer (thankfully) is if the nerve that moves the lip gets cut - this is permanent and difficult to manage. The good news is that nerve injury is far less common in Mini Lifts than in full face lifts. In your mother's case it is also good that her surgeon is comfortable that did this not happen.

Give it some more time, follow closely with the surgeon and it appears that all will be well.

Dr. J

Kamran Jafri, MD
New York Facial Plastic Surgeon

Face lift

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Nerve weakness after face lift is most commonly temporary due to nerve "fatigue", rather than actually cutting the nerve.

Wait up to 12 weeks and most probably will come back much sooner.

I hope you plastic surgeon was a Board Certified PS. Then your chances of a major problem is much less.

Samir Shureih, MD
Baltimore Plastic Surgeon

Crooked smile after facelift

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It is fairly common for patients to have some asymmetry in their smile to begin with that you may or may not have noticed before surgery. Be that as it may, some asymmetry may be due to swelling and this may take some time to resolve.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.