Facial Lipo Damage Not Getting Better After 8-weeks?

This is an injury to the marginal mandibular nerve a branch of the facial nerve.  The nerve has been bruised by the liposuction cannula.  It will take 3-6 months to show improvement or resolution. The best management at this time is observation.

Dr. ES

This is a well described motor nerve injury that is a risk in having facial liposuction.  While your motor nerve injury may be permanent, I would not give up on the nerve just yet.  It could take 6 to 9 months to see this recovery.  In the mean time your surgeon could Botox the lip depressors on the other side to reduce asymmetry.

Nerve recovery can take up to two years before one has to accept a  (permanent) nerve deficit. Most likely your facial nerve branch was bruised by the liposuction and needs to (spontaneously) recover.

Observation and patience are the treatment of choice. Maybe your Plastic Surgeon wants to send you to a Neurologist for a consultation and nerve studies. This studies very often can give you and your Surgeon a better idea about the time needed for the nerve branch to recover and what your chances are for complete recovery of the Nerve.

Good luck and lots of patience!

Thank you for your question. I realize this is a difficult time for you. You describe a facial palsy because of nerve damage(most likely temporary) to the marginal mandibular branch of the facial nerve. Two causes are either from direct trauma from the mechanical action of the liposuction or heat damage from the laser. Full function can take up a year if nerve is just bruised(neuropraxia) if cut or severely injured( neurotemises) the nerve may never work. Botox can be used on the normal side "mirror image" muscles to create symmetry by temporarily weakening these muscles.  Again, usually over time the nerve will heal and function most likely will return.

Your nerve will come back almost certain.  I am not a fan of Smart Lipo.  Possible the laser heated the nerve and it just needs to grow back.  Nerves such as this can be out up to a year but large series of study including my own indicate they nearly all return.   Mar McGregor, MD  studied many  nerve injuries and found 100% came back in a year.   In 30 years I have had a few go out but all returned.  My longest wait was 4 months.  In 30 years I had some weaknesses for a week or two and that is rare but we see it.   All came back.  I believe your nerve will regenerate.  After injury the nerve hibernates for 4 weeks and then starts regenerating.  Be patient.   Wait with patience is all you can really do.  My Best,  Dr C