Asymmetry After Mini Lift and Botox

I had a Mini Face Lift and Botox at the brow 1 month ago. On the left side of my face, my eye and mouth are uneven. It feels like nerve damage. I hope I'm wrong. Is that a possibility? I have to squint to close my eye.

Doctor Answers 5

Asymmetry Soon After Mini Lift and Botox

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Because of the limited- to no-undermining with a Mini Lift, it is unlikely to have caused nerve damage.

Your eyelid weakness is more likely from the BOTOX and should dissipate in about 3 months.

Be sure to use eye drops if you are noticing any dryness, especially at bedtime.

Healing After Minilift Procedures

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For the most part, minilifts are simple skin lifts that involve a small incision around the ears with a small amount of skin removed creating a lift along the jawline. There are many different techniques to doing this. Some may be more invasive than others. It is not unusual to have uneven puffiness related to facial procedures. You should not be experiencing problems with movement of the eyes or lips unless there is nerve damage.

It is unlikely that the facial nerve, which act on the muscles of facial expression, to be damaged by a minilift. The surgey just is not that deep... or involved. Problems with eyelid closure after BOTOX may be more likely. If this is the case, it should resolve in 1-3 months.

Henry Daniel Sandel IV, MD
Annapolis Facial Plastic Surgeon

Facial nerve injury after mini facelift

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Dear Mini Facelift Patient from Atlanta,
Mini facelift, as it sounds, requires minimal skin undermining and dissection. Not knowing what the extend of flap dissection was during your surgery, it is difficult to diagnose your problem. However, according to your description, you may have a minor facial nerve injury. Minor facial nerve injuries usually resolve with time. Talk to your surgeon and make sure you have a frequent follow up with him. Good luck and good healing….. Dr. Sadati

Uneven face and botox

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A mini facelift is unlikely to cause the concerns that you have with squinting. Some asymmetry is normal. The botox may have worked better on one side than the other.

Uneven face

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Mini face lifts have their own indications and limitations, without reviewing the operative note it is very difficult to know what was done. The addition of Botox makes things a little confusing regarding the eye.

Drooping of the mouth could be nerve injury, most of the time it does come back. You will have to wait till the effect of Botox is completely gone. if the eye and mouth uneveness continue then it probably will not come back completely. A full evaluation at that time is needed, by a board certified plastic surgeon, and a discussion of the options available.

Samir Shureih, MD
Baltimore 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.