Much Numbness and Lips Dont Work Right!

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!

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

The mid face lift is performed along the bony location where the nerves to the lips exit the skull and facial bones. The surgical intervention can result in interruption of nerve activity as well as profound and prolonged swelling producing the symptoms you describe.  

Ideally it would be best to know how long ago you had your surgery. Post-operative swelling and numbness are common issues with a midface lift. If there is swelling then motion can be impaired. Surgical stretching of the nerves can also cause numbness and, rarely, impaired motion during a midface lift. You should review your concerns with your physician as I am certain he/she would appreciate and be able to specifically answer your question as it relates to you. Be healthy and be well,James M. Ridgway, MD, FACS

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.

An important sensory nerve that exits the facial skeleton below your orbital rim (infra-orbital nerve) was likely stretched during the mid-face lift procedure. Sometimes these sensory changes take a few days to resolve. Check in with your plastic surgeon if the numbness persists beyond a few days.

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.

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.

You should talk to your surgeon who can answer this question best for you.  Likely. the infraorbital nerve has been stretched and should improve with time.

Dear jsgreen,

There are two issues going on: numbness and weakness. These are caused by two different processes: (i)trauma to sensory nerves, and (ii) trauma to motor nerves or the muscles they serve.

The key question is: How long post op are you? Numbness from your facial procedure could be prolonged if the nerve was traumatized during the procedure, and it could take a week to a number of months to FULLY return. If you are early (less the two weeks) from surgery, you should start regaining some sensation soon. The important thing is that you see SOME degree of improvement over time.

The weakness of the facial muscles may either be due to direct trauma to the muscles or the nerves that control the muscles. Again, if you are still early in your post op course, you should start to see some improvement . As a surgeon I would be concerned if you are beyond a week, and your ability to move the lips has not begun to improve. This does not necessarily mean that the movement won't come back on its own, but in general, I expect full facial movement to be seen the day after surgery.  

Best regards,

Lawrence Tong MD FACS FRCSC