A well known complication of a facelift is damage to the nerves of the face. The incidence of nerve injury after a facelift ranges from 1/200 to 1/50 cases.
The most common type of injury is to the sensory or feeling nerves. This leads to numbness. It is common in the ear and cheek skin in the first few weeks after surgery. More permanent numbness is usually due to damage to the greater auricular nerve. This nerve supplies feeling to the lower part of the ear and if damaged permanent numbness and discomfort may develop in this area. This happens in 3-5% of patients and is more common in deep dissection facelifts.
More noticeable is damage to the facial nerve which supplies movement to the face. This occurs in less than 1% of facelifts. Because swelling and bruising may cause identical symptoms in the first few weeks after surgery, weakness of the face is not always a sign of permanent nerve damage. In fact 95% of cases get complete return of function within year. It is for this reason that surgery to repair the nerve is not indicated in the first few months after a facelift.
Deep plane facelift, those that go deeper than the skin, are associated with a higher rate of injury to the facial nerve (from 1%-20%). Even in this situation most problems resolve without surgery.
Short scar facelifts, such as a MACs lift, tend to have a lower risk.