Numbness and Swelling Post-chin Implant, Neck Lift, and Lower Facelift

Question

I had chin implant with wings, a neck lift (platysmaplasty), and lower face lift over a year ago and my right lower lip and chin area is still numb and swollen. What caused this and what can be done to eliminate these problems?

Otto Joseph Placik, MD · Answer

If you continue to have unilateral numbness 1 year after the procedure, you should discuss this with your surgeon.
There are two major nerves that can be effected by chin augmentation and neck surgery. One is a motor nerve that is typically injured/bruised from the liposuction and typically accompanies chin augmentation; The other is a nerve coming directly out of the jaw bone, which provides feeling to the lower lip. There is one on both sides.
Therefore, if you have relatively symmetric numbness pain and tingling, this is most likely due to swelling and stretching of the nerve. It is likely to return because it would be very unlikely that both nerves were damaged. If you have profound numbness on one side to the point you are drooling and unable to "feel" you lower lip, I would be slightly more concerned but nevertheless, your nerve could still  recover.  
You should always keep an open dialogue with your surgeon and express your concerns.
I hope this helps.

Jed H. Horowitz, MD, FACS · Answer

Numbness or muscle weakness following a #facelift and other facial procedures is not uncommon.  When the skin is separated from the underlying tissues during #surgery, small sensory nerves are cut. Varying degrees of #numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2-6 months for face, neck and cheeks, and to 9-12 months for the forehead and scalp. Muscle #weakness may also be present around the mouth especially if liposuction is used. This typically recovers fully in the months after surgery. If you have certain concerns about the procedures and #healing process, it is recommended to call your board-certified surgeon or their medical staff and discuss those #concerns.

Stephen Prendiville, MD · Answer

Numbness of the lower lip area after a chin implant is very suggestive of inflammation of or injury to the mental nerve (the sensory nerve of the lower jaw and lip area). I would remove the implant with the purpose of allowing the nerve to recover. Sensory nerves are very resilient and recover with much greater predictability than motor nerves.

Amir M. Karam, MD · Answer

The numbness you are experiencing is likely related to the chin implant placed by you surgeon.  Either the nerve was damaged at the time of the implant placement or the implant is resting on the the nerve. This is more likely if you had a large implant placed or if the implant was placed through the mouth as opposed to under the chin. My recommendation would be to have the implant removed to see if the nerve settles down. If it doesn't, then it means the nerve was disrupted at the time of the initial surgery.  You can have the implant replaced months later if you choose.  Best of luck.  
Dr. Amir Karam

Kamran Jafri, MD · Answer

The reason your right lower lip and chin are numb is because there is a nerve that exits the jaw bone that provides sensation to those areas right were the chin implant wings are placed.

	When this nerve is stretched by the procedure or implant itself the nerve in most case recovers in a short period of time. I am concerned however that it has been a year and the nerve has not recovered yet. This could imply a more serious compression injury to the nerve. In rare cases it could even mean the nerve was cut during surgery.

	It is best you sit down with your surgeon and see if they think removing or re-positioning the implant could possibly help the nerve function improve.

Robert M. Freund, MD · Answer

There are two types of nerves in your face - 

	sensory nerves- gives your brain feedback on touch, temperature and pain.

	Motor nerves - tell the muscles to work.

	The motor nerves and sensory nerves come from different areas on your face. motor nerves do not recover well after an injury. sensory nerves can recover better, as long as the nerve is intact. The sensatio you dscribe comes from a nerve(mental nerve) that exits the lower jae bone just below the incisor. obviously, the implant can injure that nerve. Remove the implant and see what happens.

Minas Constantinides, MD · Answer

It sounds like the chin implant is either resting on or stretching the mental nerve. This is the nerve that provides sensation to your lower lip and chin area. The implant should be removed if the numbness does not improve within a few weeks. If the implant is sitting on the nerve, then your sensation should come back. If the nerve was injured during surgery, then it may be possible to repair the nerve or replace the injured segment with a nerve graft. Have a discussion with your surgeon about these options.

Pat Pazmino, MD, FACS · Answer

Experiencing some numbness is possible after a chin implant and neck lift. This may be due to some stretching or bruising of the nerves in this area. As the nerves begin to heal, you should expect to feel tingling or an electric sensation. Once the nerves heal completely, your sensation should return.

Steven Wallach, MD · Answer

Numbness after a chin implant if it is early is often due to swelling. If you are experiencing this later say a few months after surgery, then the implant may be pushing on or irritating the sensory nerve to the area or the nerve may have been injured during surgery.

Jonathan Hoenig, MD · Answer

Lower lip and chin numbness is directly related to placement of the chin implant. The swelling may be an artifact of the nerve damage. There are two options: either the nerve was damaged when the implant sugery was performed or the implant itself is resting on the nerve and impinging on it.
If the numbness is causing you distress, I suggest you have it removed to see if the problem resolves. If the implant was pressing on the nerve and you remove it, your sensation should come back within a few weeks. If the nerve was damaged, it is not likely to recover at this point regardless of whether the implant is removed, but there's no way to know until you take it out.
After removing the implant, it is possible to replace it later if you hate the way it looks without it. Alternatively, you can use an injectable filler such as Radiesse to give you a similar look without an implant.

Numbness and Swelling Post-chin Implant, Neck Lift, and Lower Facelift

Answers (11)

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