Twitching in cheek 4 months post lower facelift, will the twitches or spasms be temporary?

I had a lower facelift over 4 months ago. I also had fillers & Botox 1 week later. No Botox since. My face had felt a little more numb on 1 side up to a week ago. With the increased feeling, I am getting twitches in that cheek every couple seconds now. My questions: Will the twitches or spasms be temporary? If yes, how long? Will it get worse? Is it recommended that I get Botox in there to paralyze the muscle or will this halt any healing process?

Doctor Answers 5

Twitching in Cheeks 4 Months Post Op

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. 
Some degree of firmness or lumpiness under the skin is normal after surgery and will resolve with time. Local massage will speed resolution of this problem, which normally takes 2-4 months to disappear completely. 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.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Twitching in cheek 4 months post lower facelift

It would be most reasonable to suspect that since the twitching began as your sensation returned, these two things are most likely related and should resolve with time. As to how long it will take to resolve, that is not possible to say. Botox can be used to ameliorate your twitches and should not interfere with the healing process.I would suggest to discuss this with your plastic surgeon. Best wishes.

Pedro M. Soler, Jr., MD
Tampa Plastic Surgeon
4.9 out of 5 stars 39 reviews

Face lift, filler and Botox - now getting cheek twitches

Thank you for asking about your face lift, filles and Botox.

  • Since these twitches appeared 4 months after your face lift, it is almost certain to be temporary.
  • The twitches may be from your body adjusting to the return of feeling
  • Or it may be an effect of the Botox wearing off - twitches can occur.
  • In either case, Botox should not halt the healng process -
  • Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Facial twitching

the onset of twitches are probably do to nerves that may be reviving in the area of surgery. Occasionally inflammation in the region of dissolving sutures may be irritating muscles that are in the area.  If the the spasming muscle can be identified a small does of Botox may alleviate the twitch. By the time it wears off the muscle probably  will be back to normal. I suspect this is a temporary thing and will improve on its own as well.  

Best regard. Prashant Soni m.d.

Prashant Soni, MD
Danbury Plastic Surgeon
5.0 out of 5 stars 12 reviews


It is very unusual to get muscle twitches after a facelift. The motor nerves are in a deeper level than the surgery requires.  Perhaps there is some irritation and this should resolve over time.  I would not recommend using Botox in the lower face for spasms as this is temporary and does not address the cause of the problem.  Perhaps massage will help relieve the scar tissue that might be causing the problem.

Barry N. Silberg, MD, FACS
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 4 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.