Ultherapy Paralysis On Lower Right Side of Lip; Normal?

I had Ulthereapy 5 days ago and my jaw line is still quite swollen and tender. The thing I am very concerned about though is the fact that the lower right side of my lip seems to be partially paralyzed, is this normal and when will it start working again?

Doctor Answers 7

Marginal mandibular nerve and Ultherapy

The course of the marginal mandibular nerve varies and very occasionally, this side effect has been reported. As far as I know, all temporary paresis (weakness) have resolved based on the feedback read from other doctors who perform Ultherapy. 

I always lower my energy settings when patients feel excessive pain while working on or below the jawline to prevent this from happening. 

Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Ultherapy Paralysis

There have been several reports of temporary paralysis as a result of Ultherapy – but nothing permanent. If this is going on 5 years later, then someone needs to see you, do some tests and determine, if possible, if this was from the treatment or something else. If this is from the treatment, we all need to know it – and it may be from something else, and that is important to know as well.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 18 reviews


The mandibular nerve may have been affected by the swelling from the Ulthera treatment. This can lead to a temporary decrease in facial movement. Most clinicians mark out the location of this nerve prior to an Ultherapy treatment, so that the nerve is never treated with ultrasound waves.Perhaps localized edema form the treatment, which is a common phenomenum,occured without actual nerve injury, and once the swelling has resolved, so should the decrease in motion.

Gail Nield, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 6 reviews

Nerve weakness after ultheapy, is extremely rare but temporary

The few cases reported of nerve weakness after ultherapy seem to be temporary. If the marginal mandibular nerve is affected near the chin then there can be less depression of the lower lip on that side when opening the mouth. It can make the person appear to have had a stroke when opening the mouth. The few reported cases seem to have resolved themselves over a couple of weeks.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Paralysis from Ultherapy

Paralysis from Ultherapy is possible, but is very rare. In my experience, it has resolved after several days.  The most common side effect is numbness or tingling which can take several weeks to resolve.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

Lower lip weakness after Ultherapy

marginal mandibular nerve injury with Ultherapy is rare but reported. It is highly unlikely to be a permanent condition and will usually resolve in 1-2 weeks and may be expedited or facilitated with a short course of corticosteroid taper as per your doctor. At this point, I recommend being patient and scheduling follow up with your doctor at 1-2 weeks for evaluation if condition is not resolved.


Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon
4.4 out of 5 stars 20 reviews

Partial Paralysis after Ulthera

Because ulthera is sending energy underneath the skin it is common to be swollen and tender especially along the jawline. While having trouble with the nerves of the face is uncommon it has been reported and should resolve in 2-4 weeks.  If you are concerned I recommed consulting with the physician who performed the procedure.

Rosalyn George, MD
Wilmington Dermatologic Surgeon
4.4 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.