Nerve Damage After MACS Facelift 15 Months Ago?

I have nerve damage on my left side of my upper lip when I talk and when I smile. When you look at me at rest I look perfectly fine. My main problem is when I speak, the right side of my mouth works perfectly fine, but the left side still moves but not as much as the right looking like I talk out of the side of my mouth. I had a MACS lift, brow lift, buccal fat removal on the left cheek. My PS has said that he has never seen this and is sending me to a Neurologist. Is this permanent?

Doctor Answers 8

Buccal branch of the facial nerve injury typically recovers

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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.

Nerve Damage After Facelift

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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

Nerve Damage After MACS Facelift 15 Months Ago?

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    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

Nerve Damage after Cosmetic Facial Surgery

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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.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Nerve damage is unlikely to fully recover 15 months after a facelift.

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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.

Facial nerve damage following facelift surgery.

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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.   


Mario J. Imola, MD, DDS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 124 reviews

Nerve damage after Facelift

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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.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Nerve damage after a face lift

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Thank you for your question about your face lift result.

  • at 15 months, nerve damage is likely to be permanent,
  • the cause was most likely the MACS lift purse string buccal suture, the buccal fat removal or both.  Suture removal may - but is unlikely to - help.
  • a neurologist is worth a visit but may have little to offer,
  • I am very sorry you had this uncommon MACS lift/buccal fat removal complication. Hope this helps. Best wishes.

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.