Can FaceTite without liposuction cause Neuropraxia?

Question

I had face tight and micro needling with some fillers done a few days ago. The right side of my mouth won't move - but I am still swollen. Can this be neuropraxia?

Young R. Cho, MD, PhD · Answer

Thank you for your question.  If you had the procedure a few days ago, then chances are that you have nerve injury.  This can happen whether or not you had liposuction with your FaceTite procedure.  The vast majority of times, this resolves with time as the nerve recovers.  Depending on the degree of nerve injury, it can take days to months.  I would let your plastic surgeon know what you are experiencing so they can follow along and provide more guidance.  Occasionally, Botox can be used on the other side to help improve symmetry as nerve injury resolves.

Philip Solomon, MD, FRCS · Answer

Fortunately I have not seen this complication from facetite.  Neuropraxia is a well known complication from any facial surgical procedure and can occur from Facetite.  The nerve injury is either from direct trauma or from heat generated by  the devise.  As Facetite does not involve any cutting of tissue a nerve branch cannot be divided and therefore has a very good chance of full recovery.

Michael I. Echavez, MD · Answer

It is possible to develop weakness of movement on the side of the mouth after a FaceTite procedure without liposuction.  This issue normally resolves completely over time, but it could take several weeks.

Mario J. Imola, MD, DDS · Answer

Neuropraxia is a first degree nerve injury that interrupts the electrical function of a nerve but does not result in physical disruption of the axon or nerve "tube".  This is a self-limited injury and typically results in temporary weakness when a motor nerve is involved.  Recovery gradually returns over a variable period ranging from a few weeks to several months depending on the degree and location of the nerve injury.  FaceTite can potentially cause injury to a branch of the facial nerve known as the marginal mandibular nerve.  This nerve runs along the lower border of the mandible and signals muscles that pull the lower lip and corner of the mouth down (depressor anguli oris, depressor labii inferiorus) as well as providing tone and tension to the lower lip.  The FaceTite procedure can cause neuropraxia of this nerve either by mechanical trauma ie. the cannula bumping up against the nerve (most likely) or thermal injury (unlikely but not impossible). I understand this can be frustrating but I would encourage you to "hang in there" as the weakness will very very likely improve.Mario J. Imola, MD, DDS, FRCSC, FACS.

Michael T. Somenek, MD · Answer

The neuropraxia that can be seen after FaceTite, rare as it is, is typically transient and self-limiting. The temperatures that are used are not high enough to cause permanent injury to the nerve. A course of steroids may help this resolve.

Daryl Rheuark, MD · Answer

The practice of medicine, and surgery in particular, is a very humbling profession.  I have seen unwanted temporary, and permanent facial nerve injuries as a Otolaryngologist-Head, and Neck surgeon practicing since 1991 in just about every area of the face and neck.  Be patient, tell your surgeon about any changes, and follow their advice for full recovery.  Insist on seeing them more frequently.  They want to see you and help you through this.
 The branches of the facial nerve are very tiny ones at the midline of your face, but robust.  Any of the interventions you listed (filler, micro-needling, FaceTite RFAL, mini-liposuctioning, and local anesthetic delivery) can possibly "insult" these tiny motor branches. The likelihood of permanent nerve injury in your situation is very uncommon. Besides, branches of the facial nerve can "improve" for upwards of 6 months from injury.  You are only at day 3.
The good news is, unless the branches have been transected (cut), things should fully resolve.  I am the specialist for the care and feeding of the "Facial Nerve."  My plastic surgeon colleagues often refer their stubborn cases of facial nerve injury to me.  As such, I may prescribe oral steroids, conservative ice application, and advise to avoid any further trauma/intervention to the area in a situation like this.
Good Luck.

Jonathan Zelken, MD · Answer

Den,
FaceTite should always be coupled with at least a tiny bit of liposuction. Are you sure it was not done? This helps to remove the superheated oils created by the injured fat cells. Usually it is the liposuction, not the FaceTite that causes nerve injury as the fat pads over the jowls are sculpted and the nearby nerve branches get irritated. I wonder if the hot oils sticking around for longer irritated those nerve branches? What does your board certified plastic surgeon think?
Fortunately, almost all cases of neuropraxia are temporary. I imagine with resolution of swelling alone you will se a difference. Keep close followup with your plastic surgeon.
I hope this helps,

Can FaceTite without liposuction cause Neuropraxia?

Answers (7)

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