Facial Nerve Dysfunction After Cosmetic Procedures

Q: Facial Nerve Dysfunction After Cosmetic Procedures

Hello： Your symptoms are very similar to peripheral facial nerve palsy, primarily affecting the seventh cranial nerve. <br>The clinical symptoms include occasional numbness or stiffness in the face. <br>Due to the inability to close the eyelids, tearing may also occur. <br>Typica

Facial nerve

Hello, doctor.
Two years ago, I had a cosmetic mole removal procedure done near the inner corner of my eyebrow.
About a month later, I noticed a slight drooping of my eyelid, but since it was not very noticeable, I thought I was overreacting and did not see a doctor.
It wasn't until three to four months later, when I felt it had worsened, that I visited a rehabilitation specialist.
They informed me that I had facial nerve dysfunction, so I underwent electrical stimulation therapy and heat packs, but there was little improvement.
I then went to the hospital for blood tests and an EEG, both of which came back normal.
Now, when I look in the mirror, I notice that the drooping at the outer corner of my eye makes my eyes appear uneven, and my mouth corners are asymmetrical.
Additionally, the muscles around my eyes and mouth seem weaker, and I often feel uncomfortable, wanting to exert effort to restore my face to its original appearance.
Although it's not very obvious and others might not notice unless they look closely, I can see the difference.
I have taken medication prescribed for facial nerve issues, but the side effects were too severe, causing stomach discomfort and muscle twitching, so I stopped taking them.
After seeing several doctors who couldn't identify any specific problems, I would like to ask if it is possible that the cosmetic surgery damaged my facial nerve, and what treatment options are available?

He, 20~29 year old female. Ask Date: 2018/05/30

Dr. Jiang Junyi reply Neurology

Hello: Your symptoms are very similar to peripheral facial nerve palsy, primarily affecting the seventh cranial nerve.
The clinical symptoms include occasional numbness or stiffness in the face.
Due to the inability to close the eyelids, tearing may also occur.
Typically, the impact on facial muscles is quite extensive, as you described with the corner of the mouth and the muscles around the same side of the eye.
In the acute phase of facial nerve palsy, symptoms improve over time due to nerve damage.
The use of steroids in the first week is primarily to control inflammation and reduce the extent of nerve damage.
However, after three months, the recovery rate slows significantly.
Since your symptoms have persisted for two years, it may be necessary to prepare for the possibility that recovery could be limited.
Approximately 10 to 20% of cases of facial nerve palsy do not fully recover.
Other treatment options include medications such as vitamins and agents to improve blood circulation, as well as electrical stimulation, acupuncture, massage, low-level laser therapy, infrared irradiation, shortwave therapy, and facial muscle exercises.
Aside from steroids, there is insufficient evidence to support the effectiveness of other treatment modalities.
After the acute phase, there are very few medications that are confirmed to be helpful, and patients are often advised to take vitamin B complex as an adjunct.
The causes of the condition are usually unknown or related to viral infections, leading to impaired blood circulation that supplies nutrients to the facial nerve, resulting in dysfunction and subsequent facial muscle paralysis.
The likelihood of widespread facial nerve palsy resulting from cosmetic mole removal is extremely low.
I recommend that you consult a neurologist for discussion and treatment.
Wishing you good health and peace.
Dr.
Tao, Neurology, cares about you.

Reply Date: 2018/05/30

More Info

Facial nerve dysfunction following cosmetic procedures, such as mole removal, can be a concerning issue for patients. Your experience of noticing slight facial asymmetry and muscle weakness after the procedure is not uncommon, and it raises valid questions about the potential impact of cosmetic interventions on facial nerve integrity.

Firstly, it is essential to understand the anatomy of the facial nerve (cranial nerve VII), which controls the muscles of facial expression. This nerve runs through a narrow bony canal in the skull and branches out to various facial muscles. Cosmetic procedures, particularly those involving incisions or manipulation near the facial nerve's pathway, can potentially lead to nerve injury, inflammation, or compression. However, the likelihood of significant nerve damage from a minor cosmetic procedure like mole removal is relatively low, especially if the procedure was performed by a qualified professional.

Your symptoms, including eyelid drooping (ptosis), mouth asymmetry, and muscle weakness around the eyes and mouth, suggest a possible facial nerve dysfunction. This dysfunction could be due to several factors, including direct trauma to the nerve during the procedure, post-operative swelling, or even psychological factors such as anxiety about the cosmetic outcome. It is also worth noting that facial nerve recovery can be a slow process, and in some cases, complete recovery may not be achievable.

In terms of treatment, there are several approaches that can be considered:
1. Physical Therapy: Engaging in facial exercises under the guidance of a physical therapist can help improve muscle strength and coordination. These exercises may include gentle stretching and strengthening of the facial muscles to promote better function.

2. Medications: While you mentioned experiencing side effects from medications prescribed for facial nerve issues, it is crucial to communicate these concerns with your healthcare provider. They may be able to adjust the dosage or try alternative medications that could be more tolerable for you.

3. Alternative Therapies: Some patients find relief through acupuncture, massage therapy, or electrical stimulation. These methods may help improve blood circulation and promote nerve healing.

4. Surgical Options: In rare cases where there is significant nerve damage or compression, surgical intervention may be necessary. This could involve decompression of the nerve or other corrective procedures, but such options should be thoroughly discussed with a specialist.

5. Psychological Support: Given the emotional impact of facial asymmetry, seeking support from a mental health professional can be beneficial. They can help you cope with the psychological aspects of your condition and provide strategies to manage any anxiety or distress.

6. Regular Follow-ups: Continuous monitoring by a neurologist or a facial nerve specialist is essential. They can assess your progress and make necessary adjustments to your treatment plan.

In conclusion, while it is possible that your cosmetic procedure may have contributed to your facial nerve dysfunction, the exact cause can be multifactorial. It is crucial to work closely with your healthcare team to explore all available treatment options and to remain patient, as nerve recovery can take time. Remember, you are not alone in this experience, and many individuals face similar challenges after cosmetic procedures. Seeking comprehensive care and support can significantly aid in your recovery journey.

Similar Q&A

Understanding Facial Nerve Issues: Diagnosis and Treatment Options

Dear Dr. Gao, I consulted with a neurologist in the United States, who prescribed me Lyrica 50mg. However, I feel it only addresses the symptoms and not the root cause. Additionally, I found that the side effects are significant, and it doesn't resolve the underlying issue,...

Dr. Gao Chunde reply Neurology
If there is no muscle weakness (such as facial asymmetry or muscle atrophy), the primary approach to treatment is conservative management. There is no need for specific interventions like electromyography (EMG) or surgery (which would cause further damage), as it is merely a peri...

Facial Surgery Complications: Inability to Smile and Eye Closure Issues

I underwent a three-layer facelift surgery on September 19, and now the left side of my face cannot lift the corner of my mouth, causing my smile to be lopsided. The lower eyelid cannot close properly, relying instead on the upper eyelid to close, but it doesn't close comple...

Dr. Jiang Junyi reply Neurology
Hello, Miss: You mentioned the symptoms of "a crooked smile and the inability to close the lower eyelid," which may indicate inflammation of the facial nerve. During the acute phase, due to nerve damage, improvement of symptoms may take some time. The use of corticoster...

Uncontrollable Facial Twitches After Cosmetic Surgery: Causes and Solutions

Two years ago, I underwent cosmetic surgery to elevate my cheeks. (Below are the surgical details provided by my doctor.) After the surgery, my cheeks were quite swollen, and before the swelling subsided, my left cheek was accidentally bumped hard by my one-year-old daughter. Onc...

Dr. Gao Chunde reply Neurology
Based on the symptom description, it is more akin to facial myokymia, which refers to involuntary muscle twitching of the facial muscles. This can range from benign nerve hyperexcitability (such as eyelid twitching) to involuntary discharges due to facial nerve damage, and to spe...

Understanding Facial Numbness After Cheekbone Surgery: Next Steps

Hello Doctor, ten years ago I was in a car accident that resulted in fractures of my zygomatic bone and orbital bone. After surgery, titanium metal was placed in my zygomatic bone, and the nerve part healed on its own after six months. In recent years, I have experienced some tin...

Dr. Xiao Yongxun reply Family Medicine
Dear Mr. Yao: 1. Based on the symptoms you described, it may be indicative of the distribution of the trigeminal nerve; its branches innervate the gums and the roots of the teeth. Any changes affecting the nerve distribution could lead to sensations of numbness or pain. 2. Of c...