Right side of my top lip and surrounding areas weak after Buccal fat pad removal. Is that nerve damage? (photos)

Hello, The direct answer to your question is yes. It appears that you have encountered some injury to a branch of your facial nerve (cranial nerve 7) on the right side. The main trunk of the facial nerve enters the face under the ear and just behind the jaw and then divides into five branches each with other smaller accessory branches. This portion of the facial nerve is responsible for the movement of facial muscles.              While buccal fat removal is in general a safe and effective procedure, the facial nerve is at some risk for damage during this procedure. On occasion, during buccal fat removal, a small branch called the buccal branch of the facial nerve can be damaged.  You indicated that the right side of your face was much more swollen than the left side. It is likely that the nerve was stretched or only partially injured.  Also because the facial muscle distortion of  is only minor, it is unlikely that the main buccal branch itself was seriously injured. The weakness to the movement of your upper lip and possibly muscles near your nose on the right side is very likely temporary and the should resolve within a few months.   There really is no proven treatment to restore normal facial movement sooner. You should notify your surgeon about this issue so he or she can decide if any treatment is indicated. As with any plastic surgery, and especially if a complication is encountered, it is important to be patient during the healing process.     Finally,  encountering this complication can happen with any surgeon, even the most experienced ones. Encountering this issue does not indicate that your surgeon was negligent or “bad”.  Most every surgeon who does facial plastic procedures encounters issues like this at some point. What’s most important is that you have an open discussion with your surgeon so you both understand what has happened and what you can expect. I hope to have provided you with informative information and some reassurance.Best regards,Dr. Mitchell