A nerve was hit during facelift, causing sagging to lower corner of bottom left lip. Looks like I had a slight stroke? (Photo)

Question

Will this never heal? Or what should Surgeon do to correct

Tanveer Janjua, MD · Answer

Typically an injury to marginal mandibular nerve during facelift is from stretching.  It means nerve is bruised and will return to his full function over time.  However, there is always a small risk of nerve being cut.  Undergoing an EMG Will certainly confirm if the nerve is intact or not.  Start taking vitamin B complexes, multivitamins, warm compresses along the left side along with massage every day.  Also do frequent fascial exercises especially trying to smile and protrude your lips as if you whistling.  The more you do it the more you will stimulate to nerve.  Also hang in there as emotionally can be a roller coaster.  Stay in close touch with you surgeon.I wish you all the bestRegardsDr. J

Philip Solomon, MD, FRCS · Answer

You appear to have a marginal mandibular nerve palsy.  This nerve innervates muscles that lower the  lower  lip with smiling.  If the nerve were stretched a temporary weekness occurs known as neuropraxia.  if the nerve were cauterized or cut it will not recover.

John Michael Thomassen, MD · Answer

The side that does not go down when showing your lower teeth was the side that was injured.  It was likely injured when dissecting in your neck either from the submental incision or from the incision around the ear.  If it was only stretched, you should see gradual return of function over 3 months.  If no improvement is seen at this time, it was likely transected.  Keep in close contact with your surgeon during this time to plan repair or treatment.

Scott Trimas, MD · Answer

Typically the marginal branch will return in function up to six months after the procedure. There is nothing to do to make it heal any faster. It could be permanent but usually is from stretching the nerve or cautery injury to the smaller branches but it usually returns to normal function. If it is permanently injured, which occurs less than 1% of the time, then there are things you can do to compensate for that injury. I recommend close follow up with your surgeon.

Brian K. Machida, MD, FACS · Answer

If this was done recently, it should heal with time.  You should allow 9 to 12 months for healing after surgery.  Often the nerve comes back sooner, in about 3-6 months. There really isn't anything you can do to speed healing.  There are no medicines or treatments to speed healing or tests to order.  You need to give it time. Try not to worry and follow with your surgeon to insure proper care.

Andrew Campbell, MD · Answer

Nerve injuries are relatively rare with a facelift, but occasionally happen. If this injury of yours is due to a cautery injury (heat used to stop minor bleeding), the nerve will most likely recover within about 6-8 weeks. If the injury was due to mechanical injury during the facelift, the recovery could take longer and there is the possibility that it won't recover at all. Hopefully your surgeon has a good idea of the possible cause and thus the expected outcome. Have an honest discussion with them.Andrew Campbell, M.D.Facial Rejuvenation Specialist

Jeffrey M. Darrow, MD · Answer

It appears your marginal mandibular nerve isn't functioning.  Return of function of injury to this nerve may take up to 9 or 12 months.  You may wish to get a EMG but this will likely only confirm what you already know.  Follow up closely with your plastic surgeon so your recovery can be monitored.  To give a more balanced appearance during your expected recovery, you may wish to consider Botox to the opposite side.

Fereydoon S. Mahjouri, MD · Answer

This is a very challenging problem. If you are not seeing any improvement in 6 weeks after surgery, a consideration should be given to explore and make an attempt to repair the injured nerve by a highly skilled surgeon. However if your surgery was performed a longer time ago a reconstructive surgery to suspend/ support the corner of your mouth on the right side is another option.

Andrew G. Silver, MD · Answer

Hello judi 1, The answer to your question really depends on exactly what happened to the nerve, and how long ago your surgery was. If the nerve was simply stretched or bruised but NOT CUT, your should regain function in your lower face, but this takes time and patience. This is by far much more common than having a nerve that is cut in half. If the nerve was CUT IN HALF and not repaired, there is little chance that you will regain any function without surgical correction. Although difficult, the nerve can potentially be repaired, given you are within the correct timeframe. Please see your surgeon frequently so that your progress can be monitored closely. Hope this helps!dr. silver

Paul Blair, MD · Answer

Apparently you mandibular branch of the facial nerve was injured.  You did not say how far out you are from your lift.  In most cases the nerve is bruised and will have return of function.  However, you need to be patient.  I would wait up to a year to see if it would start functioning before determining the injury was permanent.   Botox, Dysport or Xeomin can be use on the opposite side to help even out you smile.

A nerve was hit during facelift, causing sagging to lower corner of bottom left lip. Looks like I had a slight stroke? (Photo)

Answers (13)

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