Can Damage or Compression of the Great Auricular Nerve Cause Tightness/Numbness Post Surgery?

Injuries to
the greater auricular nerve can definitely cause numbness of the earlobe and
upper neck region. This injury is usually always noted immediately following
surgery. The onset of numbness seven months following surgery makes greater
auricular nerve injury unlikely.Under these circumstances, your
tightness and numbness are probably related to swelling, wound healing and scar
formation. For this reason it’s important to consult your plastic surgeon. Your
surgeon can hopefully determine the cause of your symptoms and institute
appropriate treatment.

It is fairlycommon for patients to experience temporary numbness on both side of their facefollowing a facelift surgery. During the skin flap elevation and the surgicaldissection some of the small sensory nerves to the skin must be transected inorder to tighten the facial muscle. These nerves will regenerate over timeanywhere between 6 weeks up to a year. Damage to Greater Auricular nerve causes immediate post operative numbness to the earlobe and around the ears.It would take up to a year or two to have regeneration of the nerve and return of sensation. Numbness starting 7 months post facelift surgery may caused by suture granuloma applying compressing on the Greater Auricular Nerve.

     The great auricular nerve provides sensation to the earlobe and the numbness would be noticed after surgery and should not arise 7 months later.  I would recommend an exam by your plastic surgeon.  Kenneth Hughes, MD Los Angeles, CA

The greater auricular nerve is a sensory nerve that supplies sensation around the earlobe and the jawline area. Injury to this nerve would manifest immediately after the surgery in the form of loss of sensation in these areas.

So, your delayed symptoms are not likely to be related to an injury to this nerve. Instead, these symptoms may well be related to wound-healing and scar maturation which typically does occur several months after the surgery. Gentle massage, lymphatic massage or ultrasound therapy may be helpful in improving the feeling of tightness. Any numbness that you are feeling may well have been present earlier after the surgery but not been as noticeable to you at that time. 

Injury to the GAN typically manifests immediately after surgery, not months after.  There is no imaging that can detect the problem and no treatment that can make the nerve regenerate faster, but sensory nerves do continue to regenerate for years after the injury

Nerve injury in facelifts are uncommon and are rarely permanent. I have not had a permanent nerve injury in more than 1,000 facelifts. However, the great auricular nerve is the most common nerve that is injured. On experience, it is quite rare in that this occurs. If it does occur, then one obviously needs to make the diagnosis intra operatively and repair it with micro neuro sutures. It may take 6-9 months for reuse of the post auricular numbness in the ears.

You did not specifically state where you have numbness.  Greater auricular nerve injury will only affect a portion of the ear and won't cause any numbness on the face.  It would also present immediately and either improve or persist over time, but not present months later.  You should probably see your plastic surgeon and/or a neurologist to determine the cause.

Thank you for your question. Patients should not be concerned too
greatly about numbness, even if the area can still register pain without actual
feeling. Such symptoms usually resolve themselves within 3 months or so.

Damage to the great auricular nerve is the most common nerve that can be damaged in facelift surgery. The nerve is a sensory nerve and you would notice either complete numbness or diminshed sensation around the earlobe and into the neck  immediately following surgery. It is very unusual that you would experience numbness starting 7 months after surgery. I would follow up with your plastic surgeon for further advice.

The great auricular nerve is the most common nerve injury during a facelift. It crosses the neck muscle about two inches below the ear and can be dinged during a necklift. The injury causes numbness in the earlobe which can be temporary for many. The problem will be noticed right after the lift, never seven months later.

Best of luck, peterejohnsonmd.com