Nerve Injury After Chin Lipo. Would Like Second Opinion Re Methylprednisolone? (photo)

I had chin lipo 2 wks ago. The right side of my mouth has been paralyzed since (asymmetry when I talk, smile, open mouth). Today, I received Botox to the other side to try and even things out. The PS prescribed Methylprednisolone 4 MG for 5 days, saying that decreasing the swelling may help heal the nerve faster. I would appreciate a second opinion on whether Methylprednisolone will make a difference? I would rather not take corticosteroids if the benefits are not likely to outweigh the risks.

Doctor Answers 5

Temporary Nerve Palsy Will Improve

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Thank you for your question and photo.  The marginal mandibular nerve was bruised during the procedure...this is a known complication of this surgery.  The good news is that the vast majority of these get better with time...even without doing anything.  Your surgeon's botox treatment is absolutely the best thing to do to balance your facial muscles out until the nerve heals.  Steroids are unlikely to speed up the process and they do have side effects.  Botox, time and patience are the best treatments.  Hang in there!

Nerve Injury with Chin Liposuction

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Thank you for the picture.  You do have a injury to the marginal mandibular nerve.  If this happened during liposuction, then I would suspect that this is a traction (stretch) injury.  This is a rare event.  The steroid will reduce the swelling associated with the injury but this may not translate into a quicker recovery of the nerve's function.  Recovery is correlated with the nerve's ability to repair the damage associated with the stretch injury.  Waiting at least 3-6 months to see if the function returns is the first start. After that time frame there should be consideration of exploration but the benefits of that procedure MUST be weighed against the risks. Typically the risk far exceed the benefits.

Dr. ES

Steroids for Facial Nerve Weakness after Neck Liposuction

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Given that it has been only two weeks since your procedure, the use of oral steroids is a reasonable medical treatment to try and help decrease nerve swelling. No one can tell you how effective it will be and it would be standard therapy at this point right after surgery. The marginal mandibular branch of the facial nerve almost always recovers from being traumatized but its recovery will be slow given that it has no cross-innervations with any other branches of the facial nerve. 

Nerve Injury after Chin Liposuction

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   These injuries are traction injuries in the vast majority of cases and should get better on their own without any specific treatment.  Kenneth Hughes, MD Los Angeles, CA

Submental Liposuction and Botox

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Injury to the marginal mandibular branch of the facial nerve during chin liposuction is a relatively uncommon complication, but can certainly happen.  I agree with the Botox as the timeframe for the nerve to return to full function (and it should return to full function) is about the same as the Botox.  However, I don't think that the Methylprednisolone will make any difference at all, but has a low chance of causing any harm. 

John Bitner, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 92 reviews

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