My Smile is Crooked 23 Days Post Face and Neck Lift?
My smile is crooked and it has been 23 days post face and neck lift etc.
None of the other patients where I was had this happen and they all had face and neck
lifts.
I can only see a mild improvement in the last couple weeks.
Picture one is from about 6 days post-op, Picture 2 is today.
What is the cause and how long until it gets better?
Thanks so much for your help.
Thank you for your question!
You've submitted a photo of being 23 days after your face and neck lift surgery and
that your smile is crooked.
Well, this situation you have is based on a typically temporary trauma to a nerve called
the marginal mandibular nerve.
Now, this nerve happens to be located right around the area where the jowls are located
in the part of the mandible called the mandibular notch and that vicinity.
Now that area, the nerves gets superficial so you can imagine that that nerve that innervates
a muscle called the depressor anguli oris muscle.
This muscle, we often refer to as RAO is the muscle that is responsible for bringing the
corners of the mouth downward as part of the complex of muscles that are responsible for
smiling or showing the lower teeth specifically.
So, in fact, when people want a procedure to lift the corners of the mouth, we will
very often, in purpose, inject botox or dysport into the depress anguli oris muscle to allow
the outer corners of the lip to go up.
You see, it's the balance between the depressors and elevators of the muscle and so in your
situation, most likely, it is just some swelling that is responsible for this and as swelling
gets better, the nerve function returns.
Sometimes the nerve gets traumatized slightly but it doesn't get permanently injured.
And the term for that is neuropraxia.
The typical course for that is over several months, it tends to improve.
Initially, it can be a little bit more dramatic but as time goes on, that functions tends
to come back and in neurology, generally, people wait 3-6 months before they get concerned
about long term permanent injury.
So again, it's exceedingly rare that anybody has a long term mandibular nerve damage.
I think it's important that you continue to communicate with your doctor who probably
shared the same information with you.
So in the meantime, just follow the instructions of your doctor and I wish you the best of
the luck.
So I hope that was helpful and thank you for your question.