Lip Deformity After Lower Facelift. No Problems with Facial Movements, No Loss of Sensation, Whats Going On? Will It Recover?

Question

Hi, I have had lower facelift 15 days ago. The problem now is the disfigurement of lower lip, it goes too much on right side and becomes very lopsided. It doesnt look bad when i am not talking/eating but it becomes severly lopsided when i say certain words, like 'deformed, hope, want, do, not, no etc' or eat or lick the finger etc. it looks very bad, my face seems asymmetrical as well, with right side seems more firmer than the left side. doctor said there is no nerve damage?

Nima Shemirani, MD · Answer

Dear K76,

	A little botox to the opposite side can make the lip more symmetric as it heals

	Typically this issue is temporary and will resolve over time

	From your description, it sounds like it is a mild weakness, which is great news because these tend to recover (Obviously I cannot be completely sure unless I saw you)

	Make sure your plastic surgeon is aware and sees the same issue you do

	Best regards,

	Nima Shemirani

Andres Bustillo, MD, FACS · Answer

It seems that you may have a problem with your marginal mandibular nerve. This nerve can be at risk during facelift surgery. Speak with your surgeon and have him examine this closely. It can be a partial or complete injury. At 15 days, it is still quite early and it is likely that it will return. Your surgeon may have some insight as to whether something happened during the surgery. Good luck.

Babak Azizzadeh, MD, FACS · Answer

What you are describing sounds like weakness of the marginal mandibular nerve (a small segment of the facial nerve). It's very important that you re-visit your doctor again or seek second opinion from an experienced facial plastic surgeon to see what can be done to correct this problem.

Kenneth Hughes, MD · Answer

Facial asymmetry and asymmetry during animation is a reflection of facial nerve function.  Most of these are transient.

Paul S. Nassif, MD · Answer

Hello, and sorry to hear about the negative side effects you are experiencing. 15 days is still very soon after your surgery, and you are early in the recovery period. It is not abnormal to still be experiencing recovery issues at this time. Typically, drooping of the mouth is a side effect of temporary nerve damage. 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. In regard to the asymmetry, we all heal differently and more tightness on one side is not anything to be worried about. Massage will help improve the tight feeling, but I would not recommend doing this until you can tolerate it. From here, I would recommend speaking with your surgeon further regarding any concerns, as he/she knows the extent of your procedure and exactly what was performed. He/she may also be able to recommendations on how you may relieve any discomfort. Thank you and I hope this helps! I wish you the best of luck with the remainder of your recovery.

Shahriar Mabourakh, MD, FACS · Answer

Difference in lip appearance when speaking is due to abnormal muscle function. If this occurs after face lift surgery, it is usually due to part of facial nerve being traumatized. It most often is limited in nature and will improve over time. It is good news that at rest your lips look normal and only partial weakness when speaking. Continue to monitor it and discuss it with your surgeon.

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

There are sensory and motor nerves in the face. Even if sensation is normal, you may have something going on with a motor nerve. If your surgeon attests to no nerve damage, the nerve was most likely not cut. Time will tell. It is quite possible that you will regain function in the near future. If you do not, nerve function tests are in order.

Lip Deformity After Lower Facelift. No Problems with Facial Movements, No Loss of Sensation, Whats Going On? Will It Recover?

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