Is there permanent loss of facial sensation around incisions after a deep SMAS?

With a deep SMAS mini lift. Will there be permanent loss of facial sensation around the incisions? Or will the numbness improve over time?

Doctor Answers 6

Loss of Facial Sensation after a Facelift

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Numbness or muscle weakness following a #facelift is not uncommon.  When the skin is separated from the underlying tissues during #surgery, small sensory nerves are cut. Varying degrees of #numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2-6 months for face, neck and cheeks, and to 9-12 months for the forehead and scalp. Muscle #weakness may also be present around the mouth especially if liposuction is used. This typically recovers fully in the months after surgery. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Numb areas after facelift

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Thanks for your question. Just about every facelift patient, regardless of the type, will experience some numbness after surgery. This typically resolves within a few months. The risk of permanent numbness is more common with the deeper facelifts, especially around the ear. That is one reason I prefer the more limited-incision (mini) facelifts. Best wishes

Paul J. Leahy, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 8 reviews

Is there permanent loss of facial sensation around incisions after a deep SMAS?

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 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  The more invasive the facelift procedure, the more the skin is dissected and the longer the numbness will take to fully resolve.  This is one of the reasons, that the minimally invasive SMAS facelift is more popular with my patients. Non smiling photos of your face from the front and side would help in the evaluation. 

 Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 Alf the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed. My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews


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It may take a few months for full sensation to return but it will invariably return.  Only if a large sensory branch is cut like the superficial temporal or greater auricular nerves will sensory loss be permanent.  But these branches are usually preserved in a mini lift or normal facelift.  Best wishes, Dr. T. 

Facelifting and numbness

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thanks for sharing. With any type of lifting whether it's a mini lift of full lower facelift or any technique cutting and tightening the smas there should not be permanent numbness. Temporary numbness is normal and will continue to return from a few weeks to several months. An experienced board certified facial plastic surgeon will be able to perform a smas facelift with very little risk to any nerves and get you the best results. 

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 101 reviews

Sensory Changes Postoperatively

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Thank you for your question. All types of facelifts interrupt sensory nerves that result in postoperative numbness. Over time these sensory nerves usually heal and sensation returns over time. Typically the central face has return of sensation first and then it moves out towards the periphery around the ears. While most patients feel that there sensation does return to normal some do feel that they have some degree of numbness that persists. Sensation changes can take up to a year and occasionally longer to resolve.Best of LuckDrG

Lee A. Gibstein, MD
Miami Plastic Surgeon

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.