Nerve Damage After MACS Facelift 15 Months Ago?

Unfortunately, it sounds like that you have an injury to the Buccal branch of your facial nerve on the left.  Since it has been 15 months it is more likely that this is permanent.  In my opinion there si not much an Nerurologist can offer at this point.

Dr. ES

It sounds like you sustained an injury to the buccal branch of the facial nerve, which is closely associated with the buccal fat pad. There is substantial 'cross over' between the buccal branch and the other adjacent facial nerve branches - so its likely that you'll recover function of the muscles that this nerve controls - but this can take a long time - years in some cases.

    Nerves can recover for up to 2 years after injury, but, after 15 months, recovery is less likely.  Going to a neurologist may be helpful.  Kenneth Hughes, MD Los Angeles, CA

15 months is usually sufficient time for recovery of temporary nerve weakness due to stretching and bruising of the nerve.

Let me speculate that your asymmetrical smile is due to weakness of the zygomaticus muscles on the left, most likely a result of the buccal fat extraction on this side.

Damage to the facial nerve is an extremely rare complication of the facelift. Temporary motor weakness can be byproduct of swelling and minor trauma. This generally recovers in a matter of weeks. After 15 months is unlikely to fully recover.

Hi @GJColley,
Thanks for your question. I suspect you have nerve damage to the left buccal and possibly zygomatic branches of the facial nerve. At this point you should have improved or at the least been assessed or followed for improvement. Possibly BOTOX on the right to make it more symmetric while you recover.
The Buccal Branches are the most commonly injured nerve branches during a Facelift but they are usually the least likely to be noticed because there are so many Buccal branches that they compensate for one another.  
The Buccal Branches supply motor control to many muscles including those for flaring the nostrils (Nasalis Muscle), and lifting the upper lip (Levator Labii Superioris).
There is still hope for recovery because once a nerve branch is cut, the muscle it supplies can last 18 months before it can no longer be salvaged. And the nerve branches regenerate at an inch a month. There is still hope for you to recover and I would seek out a plastic surgeon with experience in Peripheral Nerve Surgery to evaluate you and walk you through your options.
Best Wishes,
K. Chopra, M.D.
Johns Hopkins Trained Plastic Surgeon
Face, Body and Breast Expert

Facial weakness following facelift surgery is in the vast majority of cases temporary and results from bruising of the nerve branches.  Recovery usually and occurs within 3 months and very little recovery occurs after 12 months although some improvement can still occur.  A neurology assessment can help determine if any further recovery is likely with the use of motor nerve testing.  

Mario J. Imola, MD, DDS, FRCSC, FACS.   

 

 

Dear Gjcolley, I am not sure a neurologist will be able to help with the current problem you describe. It sounds like you have nerve damage in the buccal branch which is causing the laxity on the left side of the mouth. On occasions you will see this for a few days after a facelift while the nerve may be traumatized or weakened from the procedure or the local injection however at 15 months post surgery full recovery is not very likely. I would still make an appointment with the neurologist so that he/she may provide a proper diagnosis so you may have an informed conversation with your treating plastic surgeon.  Best regards, Michael V. Elam, M.D.