Can you get nerve damage from a facelift? Plus, answers to 5 other questions about nerve damage and facelift surgery

Posted April 8, 2023 by American Board of Facial Cosmetic Surgery

A facelift, also known as a rhytidectomy, is a cosmetic surgery procedure designed to improve visible signs of aging throughout the mid-face and neck. Tailored to each patient based on their particular aesthetic goals, a facelift is intended to deliver transformative yet natural-looking results. Although face lifting procedures are generally considered to be safe when performed by an experienced facial cosmetic surgeon, there are risks involved with any surgery. 

Here, we answer 6 FAQs about potential nerve damage after a facelift and what you can do to minimize your risk of experiencing this rare but significant complication.  

1. Can you get nerve damage from a facelift?

Yes, nerve damage is a potential, though uncommon, complication of facelift surgery. While there is some variation in likelihood of this complication depending on which facelift technique is used, in all cases your surgeon will be handling tissues in the vicinity of key facial nerves as they reposition skin and underlying musculature, remove unwanted fat, and trim excess skin. 

An inexperienced surgeon can easily cause damage to facial nerves through imprecisely applied compression, stretching, cutting, or cauterization during a facelift procedure; these nuances mean it is crucial for patients to choose a board-certified facial cosmetic surgeon with extensive, proven experience.

2. How common is nerve damage after a facelift?

Nerve damage after a facelift is uncommon, and the risk of nerve damage varies depending on the patient’s anatomy, environmental factors, and the type of facelift procedure performed. There are numerous nerve bundles in the face; the Great Auricular Nerve (GAN) is the most commonly injured nerve during facelift surgery. The GAN pathway extends from the jawline up through the lower half of the ear and ends a few inches behind the middle of the ear. Some studies show that injury to the GAN can occur at a rate of 6% to 7%; however, most patients eventually regain normal sensation. Generally speaking, nerve damage after a facelift should be seen as an exception rather than a rule; working with a highly experienced facial cosmetic or plastic surgeon will help you reduce the risk of this complication.

When performed by a board-certified facial cosmetic surgeon, nerve damage following facelift surgery can be minimized or prevented.

3. What are the symptoms of facial nerve damage?

Facial nerve damage after a facelift can cause a variety of symptoms, depending on the severity and location of the injury. Nerve damage can cause pain, numbness, weakness, and partial paralysis of the face. Symptoms may also include difficulty closing the eyes or smiling, drooping eyelids or corners of the mouth, and an asymmetrical appearance. Additionally, there may be a loss of feeling in certain areas of the face, and it may also be difficult for a patient to control their facial muscles, resulting in an altered appearance and/or uneven expressions.

4. Is nerve damage after a facelift permanent?

Generally, nerve damage after a facelift is not permanent; however, in rare instances, nerve fibers may not fully heal or correctly grow back, resulting in lasting damage. While most affected patients report a partial or complete resolution of nerve damage symptoms within a few months after surgery, others may experience longer-lasting impairments to their sensory abilities and/or muscle contractions in the facial area. 

As a patient, you will also play a key part in avoiding complications: following your surgeon’s postoperative instructions over the recovery period is absolutely essential. This is because, though rare, permanent nerve damage is more likely if a wound becomes infected or if there are other issues during the healing process. 

5. How long does it take for nerves to heal after a facelift?

Facial nerve sensation will largely be restored within one to two weeks post-op; the neck area may take up to six weeks. Most patients will recover full feeling throughout their face within a few months, but it can take up to 12 months for some. 

During the recovery period, patients may experience numbness or tingling sensations as nerve endings regenerate. Common side effects of this process are swelling and temporary headaches; these symptoms typically occur within the first two weeks after surgery. Patients should watch for any signs of infection and attend all follow-up visits so their surgeon can monitor their recovery. 

Further, following all postoperative recovery instructions and guidelines on resuming normal activities will encourage a speedy recovery and support optimal results. For example, patients will typically be advised to sleep on their back and use supportive head pillows for several weeks after facelift surgery. Additionally, since smoking increases the risk of nerve damage and other complications, it is essential to avoid smoking before and after your procedure.

6. How do you restore facial nerve damage after a facelift?

Restoring facial nerve damage after a facelift typically involves a multi-faceted approach to reestablish the communication between the brain and the facial nerves. Generally, when mild nerve damage is detected, your surgeon will likely recommend medication to reduce inflammation and lessen pain associated with facial nerve damage. Botulinum toxin type A can be injected into specific sites to reduce muscle spasms that prevent healthy nerve signaling. Regimens like massage and physical therapy are also commonly recommended to improve facial muscle strength, and special exercises can be performed to help retrain facial muscles and nerves. Electrical stimulation may also be used to improve and accelerate nerve regeneration. In rare cases, specialized surgery may be required to remove the damaged section and reconnect healthy nerve ends or replace the compromised nerve with a nerve graft. 

Early diagnosis and consistent treatment is key to restoring nerve damage; if you experience this complication, your surgeon will schedule additional follow-up appointments to monitor your progress and ensure you are receiving appropriate treatment. 

Choose a board-certified facial cosmetic surgeon to minimize the risk of nerve damage. 

Increase your chances of avoiding nerve damage by choosing an experienced, board-certified facial cosmetic surgeon to perform your facelift. Appropriate board certification demonstrates your facial cosmetic surgeon has a comprehensive understanding of the underlying facial musculature including placements of each nerve bundle in the face and neck, and has extensive experience performing facelifts using the most advanced tools and surgical techniques. These credentials will ensure your surgeon also uses measures to minimize potential injury to delicate facial nerves and achieve outstanding, natural-looking results. 

About the American Board of Facial Cosmetic Surgery

The American Board of Facial Cosmetic Surgery (ABFCS) is a premier medical board solely focused on certifying facial cosmetic surgery specialists in North America. ABFCS board certification demonstrates that our diplomates have the training and expertise necessary to perform a full range of cosmetic facial procedures; ABFCS diplomates are additionally held to the highest standards of patient safety and are required to stay abreast of the latest clinical research and surgical techniques to achieve optimal outcomes. 

To find an ABFCS-certified surgeon near you, use our Find a Surgeon tool.