Nerve Damage and Second Facelift?

I had a second facelift last December and my dr advised that during the surgery, a nerve twitched so he avoided that area. In the past month or so, I have a nerve in my upper lip, left side that jumps almost constantly. You cannot see it with the naked eye, but I can feel it. Is this possibly related to the facelift? And are there any fixes? Thanks.

Doctor Answers 11

Sounds like you have muscle spasm

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Thank you for the question.  Nerves provide stimulation to muscles and sensation to skin but do not actually twitch themselves.  What you are feeling is a muscle spasm of some sort.  If the nerve was irritated or damaged the muscle spasms or twitching might be a sign of nerve repair.  I would discuss this with your plastic surgeon however most of the small nerves in this area tend to repair themselves with time.

All the best,

Dr Remus Repta

Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Muscle twitching after facelift

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If an nerve is encountered during facelift revision surgery, healing from any nerve injury may take up to 24 months to heal.  If it's within that time frame, and you have muscle weakness, then giving it more time will help.

Muscle twitching can also occur on its own, usually due to stress or other stimulants.  If you more than 2 years out, chances are it's unrelated to your facelift. 

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 50 reviews

Twitching after surgery

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From the sounds of it your doctor may have gotten near a nerve with the surgery but if you still have use of your lip and just feel some twitching, that likely represents some ongoing irritation that should get better with time.  It's very unlikely with this description that you will have permanent problems.

Twitching after Facelift - Nerve Damage?

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    If you still have full range of motion and normal facial symmetry after facelift, then the nerve may be irritated or this may be a muscle spasm.  Either way I would expect complete resolution.

Nerve damage and facelift

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Hello, and sorry to hear about the issue you are experiencing. In general, any temporary nerve damage from a facelift will usually resolve itself within 6 months to a year following surgery. It may take even longer for a complete recovery, but it really depends on the patient and the extent of their surgery.
Nerve damage from a facelift can result in facial numbness, difficulty making facial expressions, ear numbness, and drooping of the mouth and/or cheek. The problem you describe is not a typical side effect of the surgery, and could be a separate issue. I would recommend speaking with your surgeon, as he/she may be able to provide you with advice on the issue. They know the extent of your procedure and exactly what was performed. Thank you and I hope this helps.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Muscle fasciculation after nerver injury usually resolves with time.

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Nerves that are damaged, but not divided in the face usually recover completely.  Motor nerve damage as a result of a facelift is rare.  The twitching you feel is probably the result of a recovering nerve.

Nerve Problems After Facelift

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Thank you for the question. It is very difficult to give an accurate opinion without an in-person examination. However, most of the nerve problems seen after a facelift have to do with the inability to move a muscle(s) of the face or a weakness in the movement. What you described is somewhat unusual to first be noticed this far out from your surgery. It would more likely be related to the swelling that accompanies your healing which can irritate nearby nerves and so more likely to manifest itself in the early post operative period. 

The good news is that the muscle is contracting and therefore the nerve by definition has to be intact. These twitches will typically resolve on their own without any sequela. 

Best of luck.

Facelift surgery nerve injury

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Dear LarCee,

  • The good news is that the area is moving rather than weakened
  • Have you been getting enough sleep?  Sometimes muscles twitch when we are tired
  • It could also be some signs of healing that you are feeling the healing going on
  • If it is getting better (even slowly) this is also a good sign

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Nerve question after facelift

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Thank you for your question. Nerve injuries associated with facelifts are not common. When they occur, they generally affect the motor nerves to specific parts of the face, and are visible immediately after the surgery. In many instances, these injuries resolve over some time, as the nerve gradually regains its function.

The symptoms that you are describing would not be consistent with a nerve injury related to the surgery. It sounds more like a localized twitch, for which there are many causes. Many of these resolve spontaneously without us ever knowing the cause. However, if you are concerned, I would suggest discussing this with your primary care physician.

Otherwise, enjoy your facelift.

Best wishes.

Jeff Rockmore

Facelift and Nerve Issues

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Generally speaking, issues with the facial nerve are very obvious and are noticed in the immediate postoperative phase.  Most facial nerve injuries are temporary and usually resolve over time.  If a branch of the facial nerve is injured, then regenerates, a condition known as synkinesis or mass motion can develop. The hallmark of synkinesis is that the individuality of facial muscular motion is diminished and the muscles move more in groups. The complaint described in this question is unusual and requires a physical examination. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 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.