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Paralyzed Lip After Neck Lipo and Chin Implant

I had neck lipo and a chin implant 3 weeks ago. The right side of my bottom lip feels paralyzed. It won't move at all. Everything that I have read says that the lip funtion will return. I know that it will heal slowly, but shouldnt I see a little improvement after 3 weeks?

It feels like the muscle on the right side of my chin just won't move at all. When I smile, the left side moves down, and the right side doesn't move, which makes my smile look very crooked. Will I just wake up one day and be able to move it a little?

I just want some kind of sign that it is not permanently damaged. I am really worried. I read that it will heal at 1 mm a day. So after the entire nerve has healed will it start to work, or will it work a little as the nerve is in the healing process?

I am a little confused. I hope you understand what I am asking. Thank you. This picture was a few days after the surgery. It doesnt look any different after 3 weeks other than some of the swelling has gone down.

Doctor Answers 12

It will need more time

March 16th, 2009
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After liposuction alone you can get this type of lip movement asymmetry. Many times it may not be due to a nerve injury but an injury of the muscle. There are multiple muscles that help to pull the lower lip down. Both types of injury are self healing and would be expected to have a complete recovery. The fact that you had a chin implant might slow down the healing because of more swelling.
After 6 to 8 weeks would expect to see some improvement but it will still take several more months to get back to normal.

Marcus L. Peterson, MD


Saint George Plastic Surgeon
4.6 out of 5 stars 38 reviews

March 16th, 2009

It will need more time

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After liposuction alone you can get this type of lip movement asymmetry. Many times it may not be due to a nerve injury but an injury of the muscle. There are multiple muscles that help to pull the lower lip down. Both types of injury are self healing and would be expected to have a complete recovery. The fact that you had a chin implant might slow down the healing because of more swelling.
After 6 to 8 weeks would expect to see some improvement but it will still take several more months to get back to normal.


Saint George Plastic Surgeon

Normal lip function should return

May 22nd, 2009
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On a rare occasion, a paralysis of the lower lip functioning muscle known as the marginal mandibular nerve can be bruised or stretched. Simple liposuction of the neck bruised the nerve, traumatized it, but did not sever the nerve. The nerve should come back in approximately eight to twelve weeks to normal lip function.

Web reference: http://www.portlandfacial.com/chinimplants_photos.html

William Portuese, MD
May 22nd, 2009

Normal lip function should return

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On a rare occasion, a paralysis of the lower lip functioning muscle known as the marginal mandibular nerve can be bruised or stretched. Simple liposuction of the neck bruised the nerve, traumatized it, but did not sever the nerve. The nerve should come back in approximately eight to twelve weeks to normal lip function.

Learn more: http://www.portlandfacial.com/chinimplants_photos.html

William Portuese, MD

Lip movement after chin augmentation liposuction

March 11th, 2009
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There are two major nerves that can be effected by chin augmentation.

One is a motor nerve that is typically injured/bruised from the liposuction (as mentioned by Dr. Yuan) and typically accompanies chin augmentation. Injury will result in the appearance you demonstrate in the picture. Liposuction will bruise the nerve temporarily with expected recovery, whereas surgery such as a facelift may actually cut the nerve, in which case recovery may not be possible. This does not seem to be the case in your specific instance.

The other is a nerve coming directly out of the jaw bone, which provides feeling to the lower lip. There is one on both sides. Injury to this will cause numbness and tingling in the lower lip but should not effect the movement of it.

You should always keep an open dialogue with your surgeon and express your concerns.

I hope this helps.

Otto Joseph Placik, MD
March 11th, 2009

Lip movement after chin augmentation liposuction

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There are two major nerves that can be effected by chin augmentation.

One is a motor nerve that is typically injured/bruised from the liposuction (as mentioned by Dr. Yuan) and typically accompanies chin augmentation. Injury will result in the appearance you demonstrate in the picture. Liposuction will bruise the nerve temporarily with expected recovery, whereas surgery such as a facelift may actually cut the nerve, in which case recovery may not be possible. This does not seem to be the case in your specific instance.

The other is a nerve coming directly out of the jaw bone, which provides feeling to the lower lip. There is one on both sides. Injury to this will cause numbness and tingling in the lower lip but should not effect the movement of it.

You should always keep an open dialogue with your surgeon and express your concerns.

I hope this helps.

Otto Joseph Placik, MD

Paralysis should be temporary

March 11th, 2009
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I agree with all the other surgeons that this should be a temporary loss of function. The nerve during liposuction usually is not "cut" but injured to the point where it does not function. You should see slow improvement over 6-8 weeks, full recovery in several months.

Michael S. Beckenstein, MD
March 11th, 2009

Paralysis should be temporary

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I agree with all the other surgeons that this should be a temporary loss of function. The nerve during liposuction usually is not "cut" but injured to the point where it does not function. You should see slow improvement over 6-8 weeks, full recovery in several months.

Michael S. Beckenstein, MD

Marginal mandibular branch of the facial nerve injury

March 11th, 2009
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You probably have an injury to the marginal mandibular branch of the facial nerve. The vast majority of the nerve injuries are temporary and will recover over time. If you have any slight movement to your right lower lip, that is a good sign. If it is completely paralyzed at this time, it still may recover but the possibility of permanent injury is present. The 1 mm. per day rule applies to nerve injuries that do not involve transection of nerves and refers to how quickly a nerve can repair itself. Since you did not have open surgery, the chance of clean transection of the nerve and thus of repairing it surgically is highly unlikely, although needle sticks can potential transect or injury small nerves. Avulsion of the nerve with the vacuum of the liposuction is possible and would be impossible to surgically repair. Hopefullly it is just bruised or contused and repair within the nerve itself will just take time.

Robin T.W. Yuan, MD

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 12 reviews

March 11th, 2009

Marginal mandibular branch of the facial nerve injury

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You probably have an injury to the marginal mandibular branch of the facial nerve. The vast majority of the nerve injuries are temporary and will recover over time. If you have any slight movement to your right lower lip, that is a good sign. If it is completely paralyzed at this time, it still may recover but the possibility of permanent injury is present. The 1 mm. per day rule applies to nerve injuries that do not involve transection of nerves and refers to how quickly a nerve can repair itself. Since you did not have open surgery, the chance of clean transection of the nerve and thus of repairing it surgically is highly unlikely, although needle sticks can potential transect or injury small nerves. Avulsion of the nerve with the vacuum of the liposuction is possible and would be impossible to surgically repair. Hopefullly it is just bruised or contused and repair within the nerve itself will just take time.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Marginal Mandibular Nerve Palsy

July 16th, 2016
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Marginal mandibular nerve dysfunction is not uncommon after face and neck liposuction, particularly if the face gets very swollen.  Swelling pressure on the nerve can temporarily choke the nerve and cause nerve dysfunction.  Although this is temporary, it can last from 3 weeks to 3 months and slowly begins to recover.  
Michael H. Swann, MD
July 16th, 2016

Marginal Mandibular Nerve Palsy

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Marginal mandibular nerve dysfunction is not uncommon after face and neck liposuction, particularly if the face gets very swollen.  Swelling pressure on the nerve can temporarily choke the nerve and cause nerve dysfunction.  Although this is temporary, it can last from 3 weeks to 3 months and slowly begins to recover.  
Michael H. Swann, MD

Lip asymmetry after chin implant and lipo

May 23rd, 2010
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This type of injury will typically correct itself over time - usually within 3 months or so.  Some believe that continuing to try to move the paralyzed side may help speed up recovery.

Web reference: http://www.seattleface.com/html/chin_augmentation.php

Sam Naficy, MD, FACS
May 23rd, 2010

Lip asymmetry after chin implant and lipo

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This type of injury will typically correct itself over time - usually within 3 months or so.  Some believe that continuing to try to move the paralyzed side may help speed up recovery.

Learn more: http://www.seattleface.com/html/chin_augmentation.php

Sam Naficy, MD, FACS

Give paralysis 6 to 8 weeks to subside

March 11th, 2009
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Most likely, the facial nerve branch innervating the right lip (a.k.a. marginal mandibular nerve) has been stretched or bruised. Unless the nerve is transected, function usually returns to normal. Given the procedures you had, I think that it is unlikely that the nerve has been cut - your surgeon can give you some additional insight into this.

After 6 or 8 weeks, you may see a return of the muscle function. It will be slow, not overnight. I understand that this is stressful for you! Certainly, you want to stay in close contact with your surgeon.

Best of luck for fast recovery!

Frank P. Fechner, MD

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 50 reviews

March 11th, 2009

Give paralysis 6 to 8 weeks to subside

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Most likely, the facial nerve branch innervating the right lip (a.k.a. marginal mandibular nerve) has been stretched or bruised. Unless the nerve is transected, function usually returns to normal. Given the procedures you had, I think that it is unlikely that the nerve has been cut - your surgeon can give you some additional insight into this.

After 6 or 8 weeks, you may see a return of the muscle function. It will be slow, not overnight. I understand that this is stressful for you! Certainly, you want to stay in close contact with your surgeon.

Best of luck for fast recovery!

Frank P. Fechner, MD

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 50 reviews

Paralyzed Lip After Neck Lipo and Chin Implant

September 19th, 2012
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This type of nerve paresis (or weakness) can occur after liposuction alone or with a chin implant. It could also be a muscle injury as well. It usually comes back with time but may be a month or longer.

Web reference: http://www.drvitenas.com/chin-augmentation.html

Paul Vitenas, Jr., MD
September 19th, 2012

Paralyzed Lip After Neck Lipo and Chin Implant

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This type of nerve paresis (or weakness) can occur after liposuction alone or with a chin implant. It could also be a muscle injury as well. It usually comes back with time but may be a month or longer.

Learn more: http://www.drvitenas.com/chin-augmentation.html

Paul Vitenas, Jr., MD

This should be self limited

August 26th, 2010
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Your likely have an injury to the marginal mandibular branch of the facial nerve.  It is unlikely that this nerve was transected during your surgery.  If the nerve was just "bruised" it should recover with time.  If there is concern, or if you would like a definitive answer, you could pursue electromyography to determine if you have an intact nerve.  Best wishes.

Gregory Pippin, MD

Gregory Pippin, MD
Metairie Facial Plastic Surgeon
4.2 out of 5 stars 7 reviews

August 26th, 2010

This should be self limited

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Your likely have an injury to the marginal mandibular branch of the facial nerve.  It is unlikely that this nerve was transected during your surgery.  If the nerve was just "bruised" it should recover with time.  If there is concern, or if you would like a definitive answer, you could pursue electromyography to determine if you have an intact nerve.  Best wishes.

Gregory Pippin, MD
Metairie Facial Plastic Surgeon

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