Sagging/asymmetry with Nerve Damage at 28? (photo)

Hi, I'm a 28 and 3 years ago I had an injury on the left side of my face (right in photo) damaging nerves. It is only minor in a way that only I notice the difference but I have noticed that the muscles have become weaker on that side, the smile is a little crooked and it sags slightly more than the other side. The other side is also chubbier compared to the damaged side. Is there anything I can do firstly non surgically to make improvements or any issues, I'm worried it'll get worse as I age.

Doctor Answers 6

Physical therapy, nerve stimulation, camouflage

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Thank you for he question and photos.  At this point there is really only one wrong answer and that is surgery.  Whatever nerve damage has occurred surgery will not correct it  at this point.  Surgery at this point is designed only to correct significant asymmetries through static or dynamic slings/muscle grafts.  You should work on strengthening the weak muscles through therapy and nerve stimulation/emg.  Fillers and botox may help to some degree to camoflouge the mild asymmetry but should be carefully done by an expert board certified plastic surgeon. 

Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Nerve damage from 3 year old injury

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I'm sorry that you've had this issue, though you are fortunate in that the asymmetry is minor and you retain a very attractive smile.  Nerve re-growth proceeds very slowly, so I would think that this will continue to improve with time rather than get worse.  Certainly avoid any surgery, and if you can stand it, I would recommend leaving things be as you actually have less asymmetry than many women who have not had previous injury.  Intervention, even with Botox, could make things more apparent rather than less so.

Facial Nerve Palsy Stigmata

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   The residual stigmata of facial nerve palsy in your case are very subtle.  While this does create some asymmetry, injecting Botox due to diffusion radius is not so precise that this muscular imbalance could be offset to make your smile perfectly symmetric. 

Sagging/asymmetry with Nerve Damage at 28?

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Fillers or fat grafting could give a temporary improvement. But you need to consider other surgical interventions on the face. Please seek in person examinations 

Facial Nerve Damage

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There are both non-surgical and surgical ways to address facial nerve damage depending on one's condition.  To properly address your particular situation, I would recommend an in-person consultation, or at the very least, a series of specific photos.  Please consult with a board certified specialist who treats facial paralysis/paresis patients who can assist you in achieving the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Incomplete injury to the facial nerve usually recovers completely with time.

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The photo demonstrates weakness of the right side in the distribution of the buccal branch of the facial nerve.  This might have always existed (asymmetical facial expression is common) and was noticed only after the injury.  If injury did cause it, it should continue to improve.  I would check in with a surgeon who deals with facial nerve injury often.  There is some electrical stimuation therapy that might have some benefit.

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