Much Numbness and Lips Dont Work Right!

After midface lift and infraorbital rim placement, will all this numbness of face, nose (even inside), lips & teeth resolve? i cant pucker, whistle or talk normally. Will my normal lip function return? the surgery was through my mouth with entry points on each side. ive been having paresthesia since 24 hrs after surgery but no noticeable improvement. what gives?! thanks for your reply.

Doctor Answers 16

Not out of the ordinary

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Any procedure that involves the mid face works around an important sensory nerve called the infra-orbital nerve. This is a very hearty nerve and quite hard to injure. That being said - the manipulation of these areas often do cause temporary numbness. If you can feel anything at all on your cheeks and lips then you will be fine. It is more worrying if you have complete numbness (e.g. where you could stick a pin in your lip and not feel it) that would be more concerning for the nerve being truly injured. In either case be sure to check with your surgeon for a complete exam.

Much numbness and lips don't work right.

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Hello! Thank you for your question! Numbness after any surgical procedure is expected for several weeks to months following. As the nerves to the area are traumatized and will then experience a temporary neuropraxia, a transient loss of nerve conduction. This usually resolves over the next 6-12 weeks, but depending on the procedure performed, sometimes much longer. Typically this should resolve by 1 year. As it goes past this date, the likelihood of the sensation returning is small. However, it can take up to 2 years. If no return from there, it is unlikely to return. It should be discussed that persistent sensory changes may develop following any surgical procedure.  Neuropraxia after facial procedures is not uncommon and may take several weeks to months to resolve as well.  It is always a scary finding when your facial muscles aren't working, but almost routinely always return.  Follow-up closely with your surgeon for this, however. 

The usual signs of the nerves regenerating and neuropraxia resolving is itching, followed by a burning sensation and then occasional sharp, shock-like pains. These will be normal to experience, and actually a promising sign. Usually, normal sensation returns, but is is also possible to have decreased sensation or even increased sensation to the areas affected. Re-educating nerves postoperatively is often helpful and will allow proper instruction for the affected sensory nerves - methods include using different textures to the affected areas when showering, bathing, applying lotion, etc. If bothersome, there are some medications that may be helpful, including Neurontin for pain for hypersensitivity. You can try various textures such as washcloths, loofahs, cotton sheets, etc. Massaging the areas is also beneficial for the incision to make the finest scar possible. The last place to regain the sensation will be directly adjacent to the incision/scar as the nerves will make its way from the periphery to this location. If continual pain arises, evaluation is warranted. After ruling out other causes, one rare explanation may be that a neuroma has developed and may require surgical excision. This is very unlikely unless a large sensory nerve has been transected inadvertently during the procedure. Hope that this helps! Best wishes!

After midface lift and infraorbital rim placement

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You don't mention how far after surgery you are but midface surgery does have a high incidence of swelling and a higher (than face lifts) incidence of nerve weakness. Most likely your symptoms will improve over a few months

Numbness and facial weakness after mid face lift

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The Mid Face Lift is performed at a very deep layer and as such places the sensory nerve branches at more risk, IMHO, than traditional Face Lifts or the less invasive minimal incision Face Lifts.  Because the inferior orbital rim may have been used for tissue suspension, the infraorbital may have been injured that would lead to numbness of the upper lips and teeth.  Facial movements are controlled by motor nerve branches of the facial nerve and if weakened or injured during a Face Lift can lead to decreased or lack of movement of the lips, eyes, eyebrows and cheek areas.  The best person for you to ask is the plastic and cosmetic surgeon that did your Mid Face Lift.  I have performed Face Lifts for over 20 years and do not like or perform, or like, the mid Face Lift for some of the reasons that you mentioned.

Numbness and loss of lip function after Mid Facelift longer than 6 weeks may indicate nerve damage

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If you are over six  weeks post Mid Facelift and the numbness and lip function have not improved there may be a component of nerve injury.

If the nerves are just stretched and not significantly damaged much of the feeling or sensation and normal motion should return by 6 weeks.

It is important to see your doctor for an assessment. If lip motion remains a problem after 2-3 weeks many would start Direct Current Electrical muscle stimulation to keep the muscles healthy while the nerves are attempting to grow back


Phases of Healing

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Your problem may be normal if you are now in the very early phase healing, however, you did not mention how long ago your operation was. You should always see your surgeon as soon as possible. Only he/she can address your concerns and take the appropriate action.

Ivan Thomas, MD (retired)
Los Angeles Plastic Surgeon

Numbness after Midfacelift?

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I need to know how long post op you are.  This seems a little extensive but may be normal early.   After the first week you should have substantial and progressive return  of function and sensation.   In a month all sensation and movement should be normal or well on the way to normal.  So all depends on the timing.  We need some more info to say much of benefit.   Good Luck.

Numbness after facial surgery

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Without knowing how long yo are from your date of surgery, its hard to answer your question.  If its within a few days from your surgery, this should get better.  However, if your symptoms are not improving with time, then there may have been some injury or brusing to the infraoribtal nerve.  If it is bruising to your nerve, this will take several weeks to resolve.  Please talk to your plastic surgeon. This warrants medical attention from your surgeon.

Midface lift and nerve problems

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You don't say how far out you are from surgery so I can't say too much.  The infraorbital nerve sounds like it was injured and this can either be permanent if it was cut or can take months to years to fully recover if it was just bumped or stretched.  What does the doctor say?

Midfacelift and numbness

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If you are only a day or two after the midfacelift, It si fairly common to have some numbness afterwards. Some movement issue may be due to swelling as well. If concerned speak with your surgeon.

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.