Ear Numbness on One Side After Lower Facelift?

Question

I had a lower face lift 9 weeks ago. One ear is still virtually, completely numb. I have feeling inside the ear, near and around the entrance to the canal - but none on the lobe or sides or top of the ear. At the very top of the lobe, where it connects to the opening of the ear area, I have a very slight sensation in a tiny spot. I am concerned about permanent nerve damage. The other ear has regained at least 80% sensation. What should I expect?

Lewis Albert Andres, MD · Answer

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.   The Great Auricular Nerve may have some neuropraxia, or less likely damaged.  Sensation should return over weeks to months, 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!

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question.  Unfortunately, due to the incisions being close to the ear, patients often do experience a lot of pain around this area (shooting pains, numbness, itchiness).  Loss of sensitivity and numbness to the area can last up to 3-6 months, therefore you are still very early post op - please be patient and give it time.  If you have any queries regarding numbness after this, please do return to see your plastic surgeon so they can advice.Best Wishes

Kenneth Hughes, MD · Answer

Numbness of the ear at 9 weeks may be due to neuropraxic injury and should improve over several months to a year.

Paul S. Nassif, MD · Answer

It is not abnormal to feel numbness around the ear at 9 weeks following a lower facelift. Numbness may be caused by temporary nerve damage, which will usually resolve itself within 6 months to a year following surgery. It may take even longer for a complete recovery, but it really depends on the patient and the extent of their surgery. It is too soon to tell whether or not any nerve damage you are experiencing is permanent, but this will rarely be the case. I would recommend speaking with your surgeon regarding the issues you are experiencing. He/she may be able to provide some additional insight. Thank you, and best of luck with the remainder of your recovery!

Shahriar Mabourakh, MD, FACS · Answer

Numbness of the facial region is normal after a face lift. Most sensation will eventually return to normal. This may take months to occur. There are time that ear may remain numb for an extended period of time, permanent numbness is possible but rare. You are still early so give it more time and see if there is slow return of sensation.

Julian De Silva, MD · Answer

During face and neck lift surgery, the
face is rejuvenated by lifting the soft tissues that have dropped with facial
ageing and restoring them to their natural position. As part of the surgery the
excess and floppy skin that has become lax with time is partly removed. As part
of the face and neck lift surgery, it is completely normal to have a degree of
numbness around the face and neck during the healing period. The sensory nerves
that provide sensation gradually improve after surgery between 6 weeks to 6
months. Numbness during this period gradually improves as the sensory nerves
recover. It is rare for numbness to persist after 12months, however in the same
way every person has relatively unique facial characteristics, very rarely
numbness can be long lasting. Patients who have difficult adapting to this
change may also find some tightness in their neck during the healing period.
For these patients, MLD, manual lymphatic drainage a specific type of neck
massage may be effective in improving their symptoms and reducing their
recovery time.

Carlo Honrado, MD, FACS · Answer

It is still early and you are still in the healing process. The numbness in your ear on one side after your lower facelift is rather common. The fact that sensation has returned in the other ear is also encouraging, but certainly bring this question up with your surgeon and he/she can make sure you are healing as planned.

John Strausser, MD (retired) · Answer

The greater auricular nerve can be affected by neck surgery.Most of the time numbness resolves as swelling & inflammation go away.Occasionally numbness can be permanent but this is rare.

Ear Numbness on One Side After Lower Facelift?

Answers (8)

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