Facial Expression After Rhinoplasty Limited?

Question

I'm 2 month post rhinoplasty now and I may facial expression has changed completely. Smiling feels like a muscle ache in my cheeks though it has become better. But the biggest problem is that I can't wrinkle my brow. My forehead feels like paralyzed. I went to see a neurologist and he said that I have reduced sensibility on my forehead and that my face looks like I got botox. Is this normal? I wasn't told about these side effects by my surgeon.

David W. Kim, MD · Answer

At 2 months, I think it is likely you will see return of function. I must admit that I have not encountered a case like yours in which the brow movement is changed from rhinoplasty. If your surgeon worked extensively very high up on your bridge, some effect of the muscles may have ensued. But this type of thing is usually temporary and will most likely resolve over a few more months.

Ali Sajjadian, MD, FACS · Answer

Hi,

	At 2 months after your rhinoplasty, I believe that it is too early to worry about what you have been experiencing.

	Your facial expressions should be reinstated as nature takes its course, swelling subsides and your recovery process comes to an end.

	Usually it takes 12 months for end results to get established but most of the recovery is reached at about 6 months post-surgery.

	That being said, if your surgery was aggressive and considerable work was done at your nasal dorsum then neighboring facial regions are susceptible to be affected and so require time to heal.

	I understand that what you have been enduring may be stressful and somehow unbearable but patience is needed and keep a good communication with your surgeon is essential as you follow his/her instructions religiously.

	Please keep in mind that only your surgeon knows the full details of your surgery and that makes him/her a beneficial source of help to you.

	I hope this helps.

	Thank you for your inquiry.

	The best of luck to you.

	Dr. Sajjdian

Jonathan Kulbersh, MD · Answer

It is not abnormal to feel a little bit of tightness when smiling following rhinoplasty. This is mainly due to the swelling that is present.  It is unlikely that the issue you are experiencing with your forehead is a result of rhinoplasty surgery.  Even if nerve damage took place as a result of your rhinoplasty, it would not affect the nerves that innervate the muscles that control the brow.  Nerve damage following rhinoplasty can lead to the following issues:

	1) Numbness of the nose
	2) Increased sensitivity of the nose
	3) A feeling of tingling on the nose

	 

	What you are experiencing sounds like a separate issue and should be addressed as soon as possible, as it may potentially be caused by something that is more serious.  I hope this helps, and good luck!

Toby Mayer, MD · Answer

Rhinoplasty and limited facial expression are probably not related. This should resolve by itself and if not gone in another 2 months get a second opinion.

Richard W. Fleming, MD (retired) · Answer

In 35 years I've never seen limited facial expression after a rhinoplasty. If this persists get another opinion from a second neurologist.

Facial Expression After Rhinoplasty Limited?

Answers (5)