I still have a crooked smile 10 weeks Post op. And slight movement left side of nose but can’t blow my nose that side. Will this go away with time as my surgeon says do nothing. No facial exercises. Massage. Pulse or tens machine. Electric stimulation at all my left jaw is very numb
June 14, 2018
Answer: Nerve injury after facelift Hello, I am sorry that you have asymmetry with your smile. I have high hopes that this should improve at least somewhat without intervention. I want to offer more thoughtful advice, but really think you need to seek the opinion of a different, board-certified plastic surgeon. I really am hesitant to cross the line, and I may be wrong, but I am a little unsatisfied with the recommendation you've received to do nothing. Please do keep us posted.
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June 14, 2018
Answer: Nerve injury after facelift Hello, I am sorry that you have asymmetry with your smile. I have high hopes that this should improve at least somewhat without intervention. I want to offer more thoughtful advice, but really think you need to seek the opinion of a different, board-certified plastic surgeon. I really am hesitant to cross the line, and I may be wrong, but I am a little unsatisfied with the recommendation you've received to do nothing. Please do keep us posted.
Helpful 3 people found this helpful
March 7, 2018
Answer: Crooked smile. Will this go away with time? Hi, I have performed many facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts. I am sorry to hear about your change in facial movement after your facelift. You might want to discuss, with your facelift surgeon, a referral to a neurologist for nerve stimulation and testing to determine the level of facial nerve injury along with and ENT surgeon referral that's experienced in facial nerve repair. "If" a nerve repair is possible, time is of the essence. Your photos appear to show weakness on the left side of both the upper and lower lips. The lower lip weakness is caused by an injury to a single branch of the facial nerve called the "marginal mandibular" nerve that innervates the lower lip depressor muscle. This is the only innervation to the muscle that pulls down the lower lip. If the upper lip can't be raised with smiling or a grimace, this would indicate injury to the "buccal" and possibly "zygomatic" branches of the facial nerve that typically having significant cross innervation to the lip elevator muscles. Existence of injury to both areas might indicate an injury to the "main" branch of the facial nerve which could conceivably be repaired. In my experience facial nerve injury is exceedingly rare in the hands of an experienced facelift surgeon but is a possible complication. The risk increases with the more invasive type facelifts versus the minimally, invasive SMAS facelift described below. If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed. My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits: very small incisions and no incisions extend or are placed within the hair. minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned) can be performed in 90 minutes or less, with or without general anesthesia no incisions within the hair = no hair loss excess fat can be removed from the face and neck excess skin removed from the face and neck cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants most patients fly back home to parts all over the world in as little as 3 days post-op I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. If the chin is weak, this 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 placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.Hope this helps.
Helpful 1 person found this helpful
March 7, 2018
Answer: Crooked smile. Will this go away with time? Hi, I have performed many facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts. I am sorry to hear about your change in facial movement after your facelift. You might want to discuss, with your facelift surgeon, a referral to a neurologist for nerve stimulation and testing to determine the level of facial nerve injury along with and ENT surgeon referral that's experienced in facial nerve repair. "If" a nerve repair is possible, time is of the essence. Your photos appear to show weakness on the left side of both the upper and lower lips. The lower lip weakness is caused by an injury to a single branch of the facial nerve called the "marginal mandibular" nerve that innervates the lower lip depressor muscle. This is the only innervation to the muscle that pulls down the lower lip. If the upper lip can't be raised with smiling or a grimace, this would indicate injury to the "buccal" and possibly "zygomatic" branches of the facial nerve that typically having significant cross innervation to the lip elevator muscles. Existence of injury to both areas might indicate an injury to the "main" branch of the facial nerve which could conceivably be repaired. In my experience facial nerve injury is exceedingly rare in the hands of an experienced facelift surgeon but is a possible complication. The risk increases with the more invasive type facelifts versus the minimally, invasive SMAS facelift described below. If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed. My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits: very small incisions and no incisions extend or are placed within the hair. minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned) can be performed in 90 minutes or less, with or without general anesthesia no incisions within the hair = no hair loss excess fat can be removed from the face and neck excess skin removed from the face and neck cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants most patients fly back home to parts all over the world in as little as 3 days post-op I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. If the chin is weak, this 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 placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.Hope this helps.
Helpful 1 person found this helpful