Paralyzed bottom right lip after chin liposuction 3 days ago while under general anesthesia. Is this normal?

Question

The procedure was virtually painless but did notice the Dr. being a very aggressive in the area underneath the chin towards the right side & it felt like he was scraping against my chin muscle which hurt. I have zero movement in my lower right lip & feel devastated that my face may be paralyzed. Is this a sign that the nerve controlling the muscle was completely cut or is it possible that the vigorous scraping to what felt like muscle underneath my chin on the right side be what's causing this?

Richard H. Tholen, MD, FACS · Answer

Your analysis is correct--vigorous liposuction did damage your right marginal mandibular nerve, which supplies motor fibers to the depressors of the lower lip on that side. Different nerves provide sensation, which may be partially numb as well, but totally unrelated. This can happen when a surgeon trying to do the best job possible damages something other than the fat cells, and is neither malpractice nor negligence--just bad luck.Since liposuction is blunt by nature, it is virtually impossible that your nerve branch is severed. But bruised and battered--yes! This usually recovers in a few days to a few weeks, but can take as long as several months. Do not despair though things look funny when you smile for a while. This should settle down and needs nothing other than time and not worrying. Best wishes! Dr. Tholen

Joe Gryskiewicz, MD, FACS · Answer

Hi Merc,I am sorry you are having some trouble.This does happen, and resolves over time.  I have never seen a permanent case.  So keep your surgeon in the loop, and visit frequently to keep your fears in check. All the best, "Dr. Joe

Mats Hagstrom, MD (license on probation) · Answer

Nerve fibers are strong, and it takes quite a bit of force or a sharp instrument to completely cut a nerve.Nerves are covered by a fatty coating called the myelin sheath.For nerves to function properly, this fatty coating must be present.When nerves are injured but not cut, it is referred to as neurapraxia.The mildest form of this is when your leg falls asleep when you sit in a certain position for too long.The most extreme form of this is when the nerve has lost most or all of its fatty covering and will require regeneration.When this happens, nerves regenerate from the point of injury to the insertion at the muscle at about 1 mm per day.Sometimes it may take a few weeks for the process to begin.RealSelf does not like us to make references to the names of other surgeons who leave comments.You do have a response, however, from a world expert in facial nerve injuries from Massachusetts.He is well published in this field, and his answer is superb.Expect improvement, though the amount of time may vary from weeks to months.Continue your follow-up appointments with your plastic surgeon. It's important to monitor progress with photographs or video.Hang in there.Best of luck, Mats Hagstrom, M.D.

Brooke R. Seckel, MD, FACS (retired) · Answer

While it is not common paralysis of the lower lip can occur following liposuction of the neck and chin.  In most cases this is a temporary dysfunction of the marginal mandibular nerve.  If the nerve injury is temporary some recovery is seen by 6 weeks although full recovery may take significantly longer.  Please follow-up with your surgeon and if no recovery after 6 weeks then electrical studies may be done to check nerve function.

Paralyzed bottom right lip after chin liposuction 3 days ago while under general anesthesia. Is this normal?

Answers (4)

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