Facelift Surgery and facial paralysis
The safety of the facial nerve is perhaps the most important aspect of facelift surgery.
The facial nerve is distinct, and perhaps it is easy to understand why. It exits the stylomastoid foramen, then enters the core of the parotid gland. The facial nerve then bifurcates into an upper and lower division within the parotid gland. It further divides into the frontal, zygomatic, buccal, marginal mandibular and platysmal branches.
Some people may experience permanent iatrogenic facial paralysis due to extensive arborization of facial nerve branches, but this condition is rare. On its own, the frontal branch is a terminal branch with limited arborization. However, if a person suffers an injury to the frontal branch, he or she risks permanent facial paralysis.
The overall risk of permanent facial nerve paralysis in standard rhytidectomy is between 0.53% to 2.6%.There have been very few reports in the literature regarding the risk for facial nerve injury associated with more invasive facelifting procedures. The “short-flap SMAS rhytidectomy” significantly limits the risk for facial nerve injury by limiting facial subcutaneous and SMAS dissection.
1 Excerpts from Azizzadeh et al: “Master Techniques in Facial Rejuvenation”
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