Nerve Damage After Plastic Surgery

Every Plastic Surgeon's Nightmare

Young woman lying on operating table during facial plastic surgery
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Any time an incision is made in the skin, there will be nerve damage. If you have a scar, you'll notice that the sensation in the area of your scar is less than the sensation of the skin on either side of the scar. This is a minor nerve injury and eventually, it becomes barely discernible. However, the nerve damage that occurs after plastic surgery can be catastrophic.

Every Plastic Surgeon's Nightmare

Nerve damage is a serious complication that anyone considering plastic surgery must be aware of.

The nightmare of every plastic surgeon is the dreaded complication of permanent nerve damage.

While most nerve injuries are temporary, any loss of function — no matter how fleeting — generates sleepless nights for your surgeon. Even when your surgeon provides the "standard of care," nerve injuries can occur.

Elective Surgery vs. Medically Necessary Surgery

While surgical nerve injury is not always avoidable, it is especially objectionable in cosmetic plastic surgery. This is because the procedures are elective as opposed to medically necessary. If a healthy person is worse off after a procedure meant to enhance a normal structure, it can be devastating for the patient.

The Causes and Effects of Nerve Damage

Nerve damage can occur with any plastic surgery procedure. Injury occurs if nerves are stretched, cut, or cauterized.

Nerve damage includes the spectrum from sensory nerve deficits (numbness and tingling sensation) to motor nerve deficits (weakness or paralysis of certain muscles).

If a nerve is severely damaged, the effects may be permanent.

Recovery of Function After Nerve Damage

Most nerve damage will recover spontaneously within six months to a year. In some cases, it can take two to three years for complete recovery.

As nerve function returns, you may experience itching, shooting pains, and/or electrical shock sensations.

If the nerve is severed completely, then numbness and the inability to move the affected muscle are permanent. Surgical intervention is required in these cases.

Nerve Damage Associated with Specific Plastic Surgery Procedures

Specific procedures have certain outcomes if a nerve is damaged. The table summarizes which nerve injuries are associated with some plastic surgery procedures.

ProcedureEffect of Nerve Damage
Facial Enhancement
Forehead/Brow LiftLoss of motion or weakness of forehead muscles
Loss of feeling of eyelid skin, forehead, and scalp
Inability to close eyes
Blepharoplasty (Eyelid Lift)Blindness from optic nerve damage
Rhinoplasty (Nose Job)Numbness of nasal skin
Rhytidectomy (Facelift)Facial numbness
Inability to move face and make facial expressions (e.g., smiling)
Drooping of the cheek, mouth, or lips
Numbness of portions of the ear
Genioplasty (Chin Augmentation)Numbness, pain, and tingling of lips, chin, and cheeks
Lower lip drooping
Neck liftNumbness of portions of the ear
Drooping of the mouth or lips
Neck skin numbness
Breast Surgery
Breast AugmentationIncreased or decreased nipple sensation
Numbness near incision
Numbness of breast skin
Mastopexy (Breast Lift)Loss of nipple sensation
Numbness near incisions
Numbness of breast skin
Breast ReductionLoss of nipple sensation
Numbness near incisions
Numbness of breast skin
Body Contouring
Tummy TuckNumbness and tingling of abdominal skin
LiposuctionNumbness at incision sites
Numbness and tingling in liposuctioned areas

Sources:

Ghavami, A. Genioplasty. In Janis JE, ed: Essentials of Plastic Surgery. 2nd ed. Boca Raton, FL: CRC Press; 2014.

Thorne CHM, et al. Grabb and Smith's Plastic Surgery. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins (LWW); 2013.

Loftus JM. The Smart Woman's Guide to Plastic Surgery. New York, NY: McGraw-Hill Education; 2008.

Siemionow MZ, Eisenmann-Klein M. Plastic and Reconstructive Surgery. London: Springer-Verlag, 2010

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