From the Research
Facial nerve palsy occurs in approximately 0.5-2.6% of facelift procedures, with most cases being temporary, as reported in the most recent and highest quality study 1.
Overview of Facial Nerve Palsy in Facelift Procedures
The majority of these palsies resolve within 3-6 months without intervention, though permanent damage occurs in about 0.1% of cases.
- The most commonly affected branches are the marginal mandibular and temporal branches of the facial nerve.
- Risk factors include extensive dissection, particularly in the posterior region near the mastoid, aggressive retraction, and inadvertent nerve trauma during surgery.
- Surgeons can minimize risk by using careful dissection techniques, proper plane identification, avoiding excessive traction, and maintaining adequate hydration of tissues during surgery.
Management of Facial Nerve Palsy
If palsy occurs postoperatively, management typically includes:
- Eye protection with lubricants if eye closure is affected
- Possible corticosteroids to reduce inflammation
- Physical therapy
- In some cases, electrical stimulation Patients should be counseled about this potential complication preoperatively, and reassured that most cases resolve spontaneously with time, as supported by the study 1.
Prognosis and Risk-Benefit Profile
The risk-benefit profile remains favorable for facelift procedures, as permanent nerve damage is rare when performed by experienced surgeons, with a study suggesting that even in cases of post-facelift facial paralysis, outcomes can be favorable with appropriate management 1.