Does Ear Lobe Numbness After Mini-lift Always Indicate Permanent Damage to Greater Auricular Nerve?

Hello! Thank you for your question! Numbness after any surgical
procedure is expected for several weeks to months following. As the
nerves to the area are traumatized and will then experience a temporary
neuropraxia, a transient loss of nerve conduction. This usually
resolves over the next 6-12 weeks, but depending on the procedure
performed, sometimes much longer. Typically this should resolve by 1
year. As it goes past this date, the likelihood of the sensation
returning is small. However, it can take up to 2 years. If no return
from there, it is unlikely to return. It should be discussed that
persistent sensory changes may develop following any surgical
procedure.  That nerve is the most common - however, it is usually just neuropraxia with the sensation returning over weeks to months.  Only time will tell - but followup closely with your surgeon.The usual signs of the nerves regenerating and neuropraxia
resolving is itching, followed by a burning sensation and then
occasional sharp, shock-like pains. These will be normal to experience,
and actually a promising sign. Usually, normal sensation returns, but
is is also possible to have decreased sensation or even increased
sensation to the areas affected. Re-educating nerves postoperatively is
often helpful and will allow proper instruction for the affected
sensory nerves - methods include using different textures to the
affected areas when showering, bathing, applying lotion, etc. If
bothersome, there are some medications that may be helpful, including
Neurontin for pain for hypersensitivity. You can try various textures
such as washcloths, loofahs, cotton sheets, etc. Massaging the areas is
also beneficial for the incision to make the finest scar possible. The
last place to regain the sensation will be directly adjacent to the
incision/scar as the nerves will make its way from the periphery to this
location. If continual pain arises, evaluation is warranted. After
ruling out other causes, one rare explanation may be that a neuroma has
developed and may require surgical excision. This is very unlikely
unless a large sensory nerve has been transected inadvertently during
the procedure. Hope that this helps! Best wishes!

This is very common after a facelift and is usually due to the skin dissection and removal around the ear. As long as the numbness is improving, it will get better and can eke up to 6m to get 100% better. 

Numbness or muscle weakness following a #facelift is not uncommon.  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. 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.

   Numbness of earlobes is usually temporary and will resolve in a few months.  Permanent numbness is more unusual.  Kenneth Hughes, MD Los Angeles, CA

The thing to realize about the healing process from facial surgery is that the nerves of sensation are the SLOWEST to heal. Skin, muscle and blood vessels all heal fairly quickly (usually within 6 weeks), but all patients will continue to note numbness and differences in the sensation in the skin for much longer. The great news is that sensory nerves (the ones in charge of feeling on the skin) are almost always good at healing, eventually with time. Whether from a browlift, hair transplant, facelift or other procedure, it can easily take 3-6 months for a normal level of feeling to return in the area covered by a specific sensory nerve.

It will always be the case that mini-facelift incisions will cut the earlobe free so it not distorted when the facial skin is pulled back and resected. The earlobe will stay numb for weeks without an injury to the GAN. In my experience, even if the nerve is accidentally transected there may or may not be permanent numbness. There is no diagnostic test that reveals a cut nerve. Intervention may be necessary if a "neuroma" occurs at the site of the transection causing shooting pain to the ear. At 10 weeks postop some ear numbness is to be expected and the ear sensation should return to normal.

If it is primarily ear lobe and surrounding skin numbness that is the issue then you didn't have an injury to the greater auricular nerve. A greater auricular nerve injury causes a dense numbness to the entire ear and the skin surrounding it (cheek in front of the ear and the skin behind the ear). The incision made around the earlobe during a mini lift cuts through the tiny nerve fibers running through the skin causing the numbness you describe. This is normal and very common. The area of numbness will decrease slowly over a period of months and should resolve completely. It doesn't sound like you have anything to worry about (if you did have an injury to the greater auricular nerve, the area of numbness will get much smaller over time, there is nothing to be done for it now anyway,  and therefore there is no reason to do any diagnostic tests). Good luck.

It sounds very unlikely that both nerves, left and right sides, were damaged.I would also expect other symptoms besides numbness. I would wait and see if sensation starts getting better. Although you are 10 wks from surgery, your surgeon may consider prescribing an anti-inflammatory medication.

Best,

Injury to the Great Auricular Nerve unfortunately is occasionally seen post facelift. This may be due to bruising or transection (cutting) of the nerve. If the nerve has been bruised, it may take several months to recover. If was cut, it may never recover. Occasionally, injury to the nerve may be followed by the development of a neuroma (abnormal proliferation of nerve /scar tissue in the area of the injury), and this may require additional treatment by your surgeon or neurologist if painful. There are no definitive tests that could make the diagnosis so soon after surgery - usually time and patience are needed in these situations

It is normal to have ear lobe numbness following facelift surgery and should resolve in the future. Permanent numbness is very rare. Be patient.