Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Nerve Paralysis after a Facelift

Center for Cosmetic Surgery & Medi-Spa Patient

Q:  Is it normal to have facial nerve paralysis after facelift? Is it reversible, and a pretty bad neuralgia pain?  Is it normal to have facial nerve paresis after face lift, where my eyebrow won’t move & eye won’t close, is it reversible, and a pretty bad neuralgia pain around the ear/cheeks 3 weeks post-op? What kind of recovery symptoms should I expect to have? My doctor didn’t warn me of anything at all, and I am in constant pain & discomfort.

A:  So sorry for your troubles! It is expected that superficial sensory nerves to the face and around the ears will be injured as a expected side-effect of facelift surgery. This will lead to improving return of normal sensation from numbness of the front-of-face and possible tenderness behind and under the ear. 

  • ​You may wish to try cutting a OTC (over-the-counter) lidocaine patch into postage stamp size squares and place them behind the ear and over the painful site. 
  • If persistent pain continues, steroid injection can be quite helpful and release of the nerve maybe be needed.
  • With both pain and numbness, desensitization massage is helpful and
  • once the skin has complete return of circulation, ice massage is quite helpful. 

​The nerves to the muscles causing weakness when injured lie in the deeper tissues of the face. Depending on the technique performed, these nerves have a higher risk of injury but usually return to full function. 

  • ​I recommend immediate follow-up with your surgeon and a second opinion with a Physiatrist (Rehabilitation Doctor) if needed. I believe better return of function occurs when the type of nerve injury (ie. bruise versus separation) is known and the therapy can start right away. 
  • Botox to correct symmetry may be useful but requires expert skills. 

​I hope this has been helpful and you will seek care to help you resolve your troubles. All the best!


Read more about similar topics:

Facial Nerve Injury

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

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