Marginal mandibular nerve damage

Question

I had chin and neck liposuction 5 weeks ago and have marginal mandibular nerve damage as well as a lumpy chin. I am very disappointed and upset, mainly with the lower lip slight paralysis. It is better but not yet normal. Should I check with a neurologist about this or wait a little longer? Thank you.

Michael H. Wojtanowski, MD · Answer

the marginal mandibular nerve courses in the same territory where chin and neck liposuction are performed . Because these a blunt ,not sharp, procedures , permanent injury to these nerve branches is very rare. You are very early in the recovery phase, as return of motor nerve function can take much longer than than four weeks . I am encouraged that you already see some imporvment and anticipate further return of nerve function over the next 3-4 months . Discuss your concerns with you surgeon.

3-4 months you can

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many Chin Augmentations using chin implants for over 30 years.  The marginal mandibular nerve runs below the jaw and then within the soft tissue of  the marionette line (fold that runs from corner of lower lip to the jaw line).  While damage to this nerve is very uncommon, Liposuction is more likely to cause it than placement of a chin implant which is carried out below the covering of the bone (far below the area of tissue where the nerve is located).  Temporary disruption of  lower lip movement can occur after chin implant surgery and isn't from nerve damage but rather from placement of the implant below the mentalis muscle.  The muscle eventually stretches to accommodate the implant at which time the smile and mouth function is fully restored.  If the nerve was injured (paralysis would lead to a complete inability to lower the corner of the lower lip on that side), function can slowly return for a full year.  I have heard of temporary nerve damage from excessive tissue retraction during chin implant placement although there is no way to know if this happened in your particular case.  It's best that you express your concerns with your Chin Implant Surgeon.    A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.

I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.

Hope this helps.

Marginal mandibular nerve damage

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Marginal mandibular nerve damage

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