American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Facial Plastic and Reconstructive Surgery

I have facial nerve damage casued by an accident when I was young, is there a facial reconstructive surgery you can recommend to correct it??

Question: I’m 30yrs Old,Had an accident when I was 8yrs old and in d process,a left facial nerve palsy occurred which made my mouth to shift to one side whenever I laugh or smile.I’ve undergone a neuro-surgery to correct it.Though,there’s an improvement but not exactly what I want.I want to know if there’s any facial procedure dat can b done to make ma mouth and lips straight again so dat it can come back to it’s normal position because I’ve lost my Confidence ever since the accident,I hardly smile in Camera because of it. Pls kindly tell me what to do and if u can refer me to any Facial reconstructive surgeon over there.Thank you for ur Understanding.

Answer: thank you for your submission. the one negative truth is that with any facial nerve injury that is permanent, there will never be a procedure that can entirely make the face work like normal. there are only degrees of improvement but always less desirable than you would like. i would recommend finding a qualified facial plastic surgeon who specializes in reconstruction of nerve damages to see what your personal options would be. the other thing that i have found that works very well is botulinum toxin (Botox, Dysport), which can help do the opposite which is to control the good side of movement so that the two sides are more symmetrical. in addition, sometimes nerves on the bad side can have something called synkinesis in which the nerves all move in clusters like if you smile you blink. BTX can soften the areas of synkinesis as well over repeated injections. hope that helps.

I’ve been thinking about getting Botox but…

Question: Do Botox injections hurt?

Answer: Injecting anything with a needle can cause mild discomfort but that all depends on the physician’s skills and use of ancillary methods to reduce discomfort.  Numbing cream can be used for the very sensitive patient or ice can also be applied immediately before injection to chill the skin and thereby anesthetize it.  Some doctors tend to vibrate the skin a bit before injection to help with discomfort.  Finally, something that I have done in my practice that has truly helped is to stop using preservative-free saline in the reconstitution.  It is simply unnecessary and causes undue burning sensation during injection.

I’m interested in cosmetic injections

Question: How often do I need cosmetic injections after the first injections?

Answer: This really depends on so many factors.  First, areas of high mobility like the lips, smile lines, and areas around the mouth tend to suffer from absorption more readily than areas that are less mobile like the cheeks, under eyes, and temples.  Secondly, it depends on what products you are using, as some products have longer lasting timeframes in one’s body than others.  Third, it depends on how much product was placed, as placing more product may lead to relative persistence of the remaining product compared with placing very little product there. Fourth, it depends on your body’s metabolism of the product.  I have seen individuals hold products for years whereas other hold it for only a few months.  Variability truly sits with the individual person.  Speaking with your facial plastic surgeon who does your injections can help you determine based on all these factors what the likelihood of your product lasting a certain amount of time would be.

I am 35 years old and have a lot of facial wrinkles.

Question: Would Botox be a good alternative to a facelift?

Answer: Yes, absolutely.  Botox, or neurotoxin, is the preferred method to manage facial wrinkles of the upper face.  Facelifts really do not offer any benefit to wrinkles since a facelift is used to lift and suspend sagging of underlying facial muscles.  With repeated injections of Botox, the facial muscles of the upper face start to relax, and the skin begins to heal.  Long-term neurotoxins are so powerful in terms of their ability to help you with helping skin have better texture, tone, and fewer wrinkles.  Early-on consistency is the key so that over time you need less Botox.  The earlier you start the better.  If you wait until wrinkles get very deep, it takes longer to heal the skin.