How Can My Lower Lip Weakness Be Improved After Mandibular Contouring Surgery?

Q: Dr. Eppley, Last year I had mandible contouring that was especially aggressive on the right side due to bony overgrowth. Since then I’ve been hoping my lower lip asymmetry would resolve but has not. I feel the muscle pulling my lip to the right and down. My right lower lip kinda feels swollen. If I lay on my right side I drool a little bit at times. Luckily I don’t have functional problems eating, drinking. I want to try Botox and lip filler for cosmetic improvement but I want to know if there’s a permanent solution? Would a neurologist be able to fix this?

A:What you are describing is classic weakness/paralysis of the marginal mandibular branch of the facial nerve. If you are more than a year out from the surgery no further improvement in motor function can be expected. There is no method to restore motor function to that nerve branch. Botox may help weaken the good side for improved lip symmetry to the paralyzed side. Fillers can temporarily add volume to the smaller vermilion or a permanent lip volume restoration can be done with a vermilion advancement. I would always start by trying temporary measures (Botox and fillers) first.

Dr. Barry Eppley

World-Renowned Plastic Surgeon