Is it possible that I have permanent nerve damage and will experience discomfort for ever?

Question

Lip lift and chin revision not healed after 9 months. 9 months ago I had lip lift & chin revision on areas where I had silicone inject. 20 years ago. Am still experiencing symptoms that vary: burning, tingling, swelling. My board cert plastic surgeon says It’s because he removed silicone in those areas. Upper lip is uneven and chin is bumpy + dimples. He sold me dysport to immob. and even the chin. It’s helping the appearance a bit but is temporary and costly.

David J. Levens, MD · Answer

It can take up to 2 years for sensation to return completely so there still is hope. Burning and tingling actually can be positive signs for nerve activity/regeneration. Persistent swelling at 9 months is not typical unless there is an inflammatory reaction perhaps to residual silicone or some type of infection.  "Uneven-ness", bumpiness and dimples can occur with any surgery especially corrective as with prior silicone injections. Further treatments as your plastic surgeon has recommended both non surgical as with injectable toxins and/or fillers or possibly further surgery can be helpful and may be indicated.

Miguel Mascaro, MD · Answer

The nerves that innervate the chin area come from the sides of the jaw line...they are rather fragile and recovery can take some time. The good news is that they are not completely damaged - otherwise you'd have no sensation at all.  burning, tingling, little zaps of lightning so to speak, are all signs that the nerves are actively trying to heal and reconnecting.  This can take quite some time, and although you are already nine months out of surgery, don't be surprised if it takes quite a few more months to settle down.  Swelling likewise, as your body is still recovering from having silicone removed from an area that is in constant motion.  As far as your upper lip is concerned, it depends on exactly what was done to be able to give you some more insight.  I hope some of this helps! Best of luck.

Nirmal Nathan, MD · Answer

Dear sheysa1,Thank you for your question. The nerves that innervate the chin come out from the lower jaw and send their branches outwards. Surgery and inflammation can produce numbness and sometimes nerve pain symptoms. Revision surgeries increase this risk. At 9 months, if you are still seeing improvement of your symptoms I would continue to wait. Massage and time will usually help. Unfortunately without examining you it is hard to comment about ways to help you.Good luck, Nirmal R. Nathan, M.D.
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgeons
  
ACGME-Trained Craniofacial Surgeon

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