Neuropathy 2 years post lower facelift - what should I do?

There could possibly be a neuroma of one of the larger peripheral nerves (greater auricular, transverse cervical, etc). It is not incorrect that some of the symptoms/signs you are reporting are related to nerve regeneration. A neuroma is when a nerve is "stuck" in a spot regenerating and can cause tingling/pain/discomfort with touch. I would potentially seek a second opinion with a specialist. For example, Babak Azzizadeh specializes in managing nerve complications after facial surgery.

Thank you for raising this important and very valid concern. I'm truly sorry to hear that you're still experiencing significant neuropathic symptoms—such as pain, tingling, and numbness—two years after your lower facelift. Given your history of fibromyalgia, it's understandable that this ongoing discomfort is both physically and emotionally distressing.

While neuropathic symptoms are an uncommon complication following a facelift, they can occur—particularly in areas where skin flaps have been raised and small sensory nerves may have been transected during surgery. In most cases, these nerves gradually regenerate and symptoms improve over time. However, in some individuals, especially those with pre-existing conditions like fibromyalgia (which can amplify pain sensitivity), this healing process may be prolonged or incomplete.

If symptoms persist beyond a year and significantly affect your quality of life, it may suggest more complex nerve involvement or heightened central sensitisation. At this point, it would be reasonable to seek a referral to a neurologist or a pain management specialist. They can offer further evaluation and potentially initiate neuropathic pain management strategies.

It’s also important that you feel heard and supported in your recovery. If you're finding it difficult to have open conversations with your original surgeon, you may want to consider getting a second opinion from another board-certified facial plastic or reconstructive surgeon who can assess your current condition more objectively.

You absolutely deserve clarity and a treatment pathway that addresses your pain—not dismissal. Please don’t lose hope; there are still avenues to explore and support available to help you feel better.

This is very unusual after a facelift. Was subplatysma dissection performed? The exact procedure and any additional modalities used would need to be detailed to understand what may have happened. The exact location of the pain needs to be detailed to understand the cause and attempt to ameliorate it.

There are no larger, visible nerve branches involved in innervation of the neck; there is a number of small, practically invisible nerve branches that are supplying neck sensation. In the process of neck lift the entire neck skin is lifted of the underlying tissues and nerve supply is completely severed. Process of reinnervation is based on nerve sprouts reaching the target organs in the skin; very elaborate and time consuming process. That is why the neck is the last area of the face/neck lift to receive complete reinnervation, sometime over 2 years. In the process of nerve regrowth some of the sprouts may become entrapped in the scar tissue which is perceived as a pain. Injection of diluted corticosteroid solution into and around painful spots may create improvement as well as desensitization (physical therapy, massage). Hope that this helps.

You don’t mention whether your ear is numb also. If your ear is numb you might want to get a second opinion.

Although unlikely neuropathy lasting 2 years after a facelift can happen. You should see a neurologist as they can use certain meds to decrease the pain and tingling. Also try to reduce stress as it can make the sensation even worst.
Regards
Dr. Janjua

Given the duration of your symptoms, it's definitely been long enough for scar tissue and other such aspects of healing to have worked themselves out.

You should start by seeing a neurologist. They will take a detailed history and give some potential options to help you. If they feel that the symptoms are localized enough (i.e., to a specific peripheral nerve), they may refer you to a peripheral nerve surgeon for possible decompression or exploration or ablation.