Permanent or temporary nerve damage?

Question

Hi, three weeks ago I had facetite and lipo done on my neck and jowls. I swelled quite a bit so after a week the PS called in a steroid pack prescription to take. That helped a lot but I still have asymmetry in my mouth when I speak. The doctor said that facetite uses nothing sharp enough to cut a nerve and this will go away eventually. I'm starting to get really scared though. Any opinions would be very appreciated! Thank you in advance!

Michael I. Echavez, MD · Answer

Your doctor is correct in that FaceTite does not use any sharp instruments and there should be no nerves that are cut during the procedure.  Any asymmetry to the movement of the mouth should be temporary but it can take several weeks to improve.  You should get return to normal movement over more time.

Munir Somji, BSc, MBBS · Answer

Hi there. This is a consequence I always consent for. Unfortunately, the marginal mandibular sits in and around the jowl area so there will always be a degree of irritation of the nerve when treating the jowls. There is minimal risk of severing the nerve answer causing permanent side effects. Most cases wear off after 4-8 weeks so not to worry :)

Christie Prendergast, DO · Answer

Temporary nerve palsy can happen after FaceTite and/or neck liposuction procedures. This will resolve with time and is usually temporary. If it persists for a few months you may consider botox to help improve symmetry while its healing.

Timothy A. Janiga, MD, FACS · Answer

There are no sharp objects used with FaceTite and so it is unlikely that the nerve is divided.  It is possible for the nerve to get bruised (neuropraxia) and have decreased function for a period of time.  I would expect this to continue to get better.  Take care and be patient.   Timothy A. Janiga MD, FACS

Robert Whitfield, MD · Answer

Although I have not seen this happen with FaceTite it is most like secondary to swelling in the region of the nerve.  Once the swelling completely resolves the majority of this asymmetry will as well.  I use arnica and other anti-inflammatories as well as ice to resolve swelling as quickly as possible.

Mario J. Imola, MD, DDS · Answer

The asymmetry seen around the corner of the mouth and lower lip following FaceTite RFAL (radiofrequency assisted lipocountouring) of the jawline and neck is the result of injury to a branch of the facial nerve known as the marginal mandibular nerve.  The marginal mandibular nerve provides innervation to muscles associated with tensing and pulling down the corner of the mouth and lower lip as well as tensing the chin (depressor angular oris, depresor labii inferiororus, mentalis).  Weakness of these muscles produces the classic appearance of a raised lower lip and corner of the mouth on the affected side.  The effect is moe dramatic during grimacing and smiling compared to 'at-rest' posture.  
The marginal mandibular nerve passes along a line paralleling the lower border of the lower jaw  (mandible) and therefore is 'in-play' when using the FaceTite canula to rejuvenate the jawline.  The injury can be the result of either:
Mechanical trauma - repeated 'bumping' up of the RF canula (or liposuction canula if this is also performed) against the nerve resulting in a brusing type injury known as neuropraxia.  This injury recovers in virtually all cases but the time for full recovery can range from a few weeks to several months (usually 4 to 8 wks).  Thermal tauma - this is much less common and results from prolonged exposure to deep heating.  This type of injury can be more severe ie. axonotemesis or neurotemesis and full recovery is possible but less promising.  .  In your situation, I would be patient because recovery will almost certainly happen. 
Mario J. Imola,  MD, DDS, FRCSC, FACS.

Permanent or temporary nerve damage?

Answers (6)