Lip Paralysis After Scar Revision

I had a scar under my lower lip revised 2 months ago. Since then, my smile has been lopsided, pulling up on the right side. My sugeon insists that he never touched any of the muscles. Could this possibly be permanent due to nerve damage? Maybe something was cut in the chin when the surgeon did the revsion. He did say he pulled the skin all the way down to move scar tissue from my chin implant. Can surgery repair this problem? I am really devestated.

Doctor Answers 2

May be a normal consequence of the healing process

Although there are possible causes for this including muscle and nerve damage, I would surmise that this is most likely due to swelling and scar tissue that will resolve with time. The lip is easily influenced by swelling which can interefere with function. It is common after rhinoplasty for the upper lip to not move as well. Similarly, it is common for the lower lip to not move as well after chin surgery where no true damage is done. I would rely on your surgeon's recommendations for now. Typically, it can take 3 months after surgery for scar tissue to soften. Scar massage may help improve resolution of swelling.

Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Problem may be due to nerve damage

The marginal mandibular nerve and the depressor labii muscles are responsible for movement of the lower lip. One of these may have been injured during your scar revision surgery. It's possible that the nerve is simply bruised in which case it's just a matter of time until the function returns, sometimes up to a year. In the meantime, you can consider adding a drop of Botox on the opposite side to weaken that muscle and improve asymmetry during the healing process.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 40 reviews

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