What fiscal therapy do you recommend for facial paralysis after chin lipo? (Photo)

It is the marginal mandible nerve that rarely gets contused (bruised) after chin liposuction. It is essentially a waiting game of anywhere from 3 - 6 months until nerve function return completely. Occasionally Botox may be given into the normal side (depressor anguli oris muscle) to balance the effect. Glad to help.  

Marginal mandibular nerve paralysis after neck liposuction, as demonstrated in your photo, is usually temporary and caused by stretching not cutting the nerve. I'm not sure if prednisone would help or not, and I'm not aware of any useful adjunct therapy other than tincture of time.Hope this helps, and keep us posted.Dr. Joseph

Dear Sebastian0325,



The other doctors are correct regarding the nerve
which is not functioning well. That marginal mandibular nerve on the right side
causes the muscles of the right lower lip to pull downwards when smiling. Since
it is not functioning, you are seeing the asymmetric smile. If the surgeon
indeed only did liposuction with a cannula, we would assume that the nerve is
intact, and this is considered a neuropraxia which will resolve with time. I
think it is important, though, that you be certain that only liposuction with a
cannula was done. If there is a particularly long scar under the chin, it is
possible that cutting or dissecting with scissors was done, and that would be a
much more ominous situation in which the nerve would have been at risk of being
severed. If you find very small incisions of no more than a few millimeters,
you should feel comfortable that this was liposuction with a cannula only, and
you should have a good result but may have to wait it out several months.



I hope this is of help to you.



Sincerely,

Robert D. Wilcox, M.D.

Was your doctor a boarded PS? Has there been any minimal improvement in motion? Best to see neurologist ASAP... 

This is fortunately uncommon. The good news is that cutting of this nerve with liposuction cannula is uncommon. Most often the nerve has only been stretched and will begin to function (first a little and then continued improvement) within 3-12 months. Botox can be very effective on the opposite side to temporarily reduce the asymmetry. Time will tell but hopefully this will improve as that nerve heals. I hope this information is reassuring for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

There is a previous response by one of the foremost experts on facial nerve injury in the world.Realself does not like for us to mention the names of other providers, so I will leave it as he works in Massachusetts.When nerves are injured from liposuction, they are generally not cut.The damage comes from a fatty layer covering the nerve, called the myelin sheath, being damaged.This is called neurapraxia.The mildest form of neurapraxia comes from pressure on a nerve.That's what happens if your legs are crossed and your foot goes numb.The longer the pressure is on the nerve, the longer it takes to recoup.A more severe level of injury can take a few weeks to recover.If the nerve is badly damaged, it needs to regenerate.That can take weeks to months.Generally, the type of nerve damage you have heals without a need for intervention.If you are not getting function back by two months, then talk to your plastic surgeon about nerve stimulation.Regardless, stay in close contact with your plastic surgeon and let him or her know how you're doing.It's a good idea to document your lip movements with photographs and/or video.Your plastic surgeon should be doing this.It allows both of you to see progress when the function comes back.In the interim, hang in there.Best of luck,Mats Hagstrom, M.D.

Thank you for your question.  You're still very early after your procedure.  6 weeks is an important time.  Landmark for recovery of function after injury to the marginal mandibular nerve after chin liposuction.If it 6 weeks you have no return ask your plastic surgeon about the possibility of Direct Current Muscular stimulation which can help preserve muscle function while nerve regeneration occurs.  And EMS direct-current electrical stimulator can be purchased by your physician through Med Labs in Goletta California.