I Had a Facelift and my Smile Seems Asymmetrical; is This Temporary or a Mistake?

I had a facelift a month ago and my upper lip seems to go up asymmetrically; have some pulling to one side. No total paralysis on either side, but definitely when I show my upper teeth, some asymmetry. Is this temporary or a mistake/permanent?

Doctor Answers 12

Smile asymetry after facelift should recover by 6 weeks

Thank you for your question. The side that looks high when you smile is the normal smile. The Buccal Branch of the Facial Nerve on the other, lower side has some form of injury.

Fortunately the Buccal Branch has many interconnections and almost always recovers.

I Had a Facelift and my Smile Seems Asymmetrical; is This Temporary or a Mistake?

Dear Monicasun

thank you for your question.  It sounds like you have a little nerve traction injury, or the facelift pulled a little on the nerve.  It sounds pretty minimal and will likely completely resolve with time.  This can take 6 months to a year to fully resolve.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 48 reviews

Asymmetry after facelift

Hello, and sorry to hear about the issue you are experiencing. It is possible you may be experiencing some temporary nerve damage. The side effects of temporary nerve damage may include the following:

1) Numbness of the face
2) Difficulty making certain facial expressions
3) Ear numbness
4) Drooping of facial features (mouth or cheek)

In general, most temporary nerve damage that occurs from a facelift will be resolve in anywhere from 6 months to a year. It may take longer for a complete recovery, but it depends on the patient and the circumstances of the issue. I would recommend communicating any concerns to your surgeon, as they know the extent of your procedure and exactly what was performed. I hope this helps, and I wish you the best of luck.

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

Assymetry after facelift

At a month it is not unusual to have a little asymmetry.  You will be fine.  Swelling about a nerve and the general healing  process causes this.  By the time you are at 3 months and 75% healed you will be fine.  Healing takes a long time.  Remember 90% at 6 months and not 100% till 12 months.  My Best.  Dr C

George Commons, MD
Palo Alto Plastic Surgeon
4.5 out of 5 stars 36 reviews

Normal facial function should always return after a facelift.

Minor trauma to a motor nerve during the facelift might generate temporary asymmetric movement. This should be very uncommon but will resolve. Make certain however that the asymmetry was not present prior to the operation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Asymmetry after Facelift

There are three possible reasons for the asymmetry you describe: swelling, asymmetric surgical technique, and nerve injury. Swelling will resolve, and even asymmetrical pull during you surgery should even out with time. If nerve injury is not "total" it virtually always resolves  with time as well.

Roy A. David, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 23 reviews

Asymmetry with smile after facelift

Some asymmetry after a facelift is not uncommon often due to swelling. Remember that likely you had some asymmetry  before but did not notice it.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Smile asymmetry after facelift should resolve

Some asymmetry with facial animation for the first few weeks following a facelift is generally not cause for concern.  There may be a small amount of traction on branches of the facial nerve while the tissues heal. This is expected to resolve over several weeks.

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

Asymmetry of your smile likely will self correct.

Your facelift was only one month ago so your tissues are still recovering.  Depending on what type of facelift you had there are several reasons for the asymmetry, from swelling, sutures and scarring.  The vast majority of these problems are temporary and the next few months should see your smile return to normal.  Be sure to follow up closely with your plastic surgeron so this can be followed.

Jeffrey M. Darrow, MD
Boston Plastic Surgeon
5.0 out of 5 stars 99 reviews

Asymmetry after facelift

The asymmetry was likely present preop, and will be obvious on your before photos; pts tend to scrutinize their faces after surgery and 'find' differences post op. that being said , you are only a month so you still have swelling and healing that is occurring, by 2-3 months everything will settle down better and any obvious asymmetry that was not present preop should resolve.

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 90 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.