Skip to main content

Nerves Injuries During Rhytidoplasty: How to Avoid and Surgical Reparation

  • Chapter
  • First Online:
Aesthetic Facial Surgery
  • 1480 Accesses

Abstract

Nerve injury in facial aesthetic surgery is not rare. Specially in facial lifting, the injuries may occur in the sensory and motor nerves. In this chapter, we describe the most injured nerves during face-lifting and our approach in terms of clinical and surgical treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Viterbo F, Faleiros H, Rodrigues AC. Inervação da Face. In: Petroianu A, editor. Anatomia cirúrgica. Cap. 20. Rio de Janeiro: Guanabara Koogan; 1999. p. 128–41.

    Google Scholar 

  2. Liu X, Daugherty R, Konofaos P. Sensory restoration of the facial region. Ann Plast Surg. 2018. Ann Plast Surg. 2019;82(6):700–7.

    Article  CAS  Google Scholar 

  3. Gosain AK, Matloub HS. Surgical management of the facial nerve in craniofacial trauma and long-standing facial paralysis: cadaver study and clinical presentations. J Craniomaxillofac Trauma. 1999;5(1):29–37.

    CAS  PubMed  Google Scholar 

  4. Moin A, Shetty AD, Archana TS, Kale SG. Facial nerve injury in temporomandibular joint approaches. Ann Maxillofac Surg. 2018;8(1):51–5.

    Article  Google Scholar 

  5. Al-Moraissi EA, Ellis E, Neff A. Does encountering the facial nerve during surgical management of mandibular condylar process fractures increase the risk of facial nerve weakness? A systematic review and meta-regression analysis. J Craniomaxillofac Surg. 2018;46(8):1223–31.

    Article  Google Scholar 

  6. Daane SP, Owsley JQ. Incidence of cervical branch injury with “marginal mandibular nerve pseudo-paralysis” in patients undergoing face lift. Plast Reconstr Surg. 2003;111(7):2414–8.

    Article  Google Scholar 

  7. Peter J, Millett PJ, Romero A, Braun S. Spinal accessory nerve injury after rhytidectomy (face lift): a case report. J Shoulder Elbow Surg. 2009;18:E15–6.

    Article  Google Scholar 

  8. Wilhelmi BJ, Mowlavi A, Neumeister MW. The safe face lift with bony anatomic landmarks to elevate the SMAS. Plast Reconstr Surg. 2003;111(5):1723–6.

    Article  Google Scholar 

  9. Rammos CK, Mohan AT, Maricevich MA, Maricevich RL, Adair MJ, Jacobson SR. Is the SMAS flap facelift safe? A comparison of complications between the sub-SMAS approach versus the subcutaneous approach with or without SMAS plication in aesthetic rhytidectomy at an academic institution. Aesthetic Plast Surg. 2015;39(6):870–6.

    Article  Google Scholar 

  10. Hinderer UT, Urriolagoitia F, Vildósola R. Neural risk zones in rhytidectomy. Handchir Mikrochir Plast Chir. 1986;18(6):370–5.

    CAS  PubMed  Google Scholar 

  11. Chopra K, Kokosis G, Slavin B, Williams E, Dellon AL. Painful complications after cosmetic surgery: management of peripheral nerve injury. Aesthet Surg J. 2019;39(12):1427–35.

    Article  Google Scholar 

  12. Lewin ML, Tsur H. Injuries of the great auricular nerve in rhytidectomy. Aesthetic Plast Surg. 1976;1(1):409–17.

    Article  CAS  Google Scholar 

  13. Al-Qattan MM. Prevention and treatment of painful neuromas of the superficial radial nerve by the end-to-side nerve repair concept: an experimental study and preliminary clinical experience. Microsurgery. 2000;20(3):99–104.

    Article  CAS  Google Scholar 

  14. Terzis JK, Kostas I. Vein grafts used as nerve conduits for obstetrical brachial plexus palsy reconstruction. Plast Reconstr Surg. 2007;120(7):1930–41.

    Article  CAS  Google Scholar 

  15. Viterbo F, Reis F. Cap. 16. “Princípios de Reparação Microcirúrgica de Nervos Periféricos. Enxertos de Nervos”. In: Cirurgia plástica: para a formação do especialista, vol. 1. 1st ed. São Paulo: Editora Atheneu; 2011. p. 159–65.

    Google Scholar 

  16. Viterbo F. Paralisia facial. In: Carreirão S, Cardim V, Goldenberg D, editors. Cirurgia plástica. Cap. 37. São Paulo: Sociedade Brasileira de Cirurgia Plástica, Editora Atheneu; 2005. p. 225–35.

    Google Scholar 

  17. Viterbo F, Romão AM. (Re)Habilitação Fonoaudiológica – Avaliação da Eficácia. Audiologia, Linguagem, Motricidade Orofacial, Voz e Conteúdo Multidisciplinar. In: Berretin-Félix G, et al., editors. Reabilitação em Paralisia Facial. Cap. 12. São José dos Campos: Pulso Editorial; 2009. p. 150–8.

    Google Scholar 

  18. Viterbo F. Cap. 14: Microcirurgia. In: Cirurgia plástica: bases e refinamentos. 1st ed. Curitiba: Edição do autor; 2011. p. 114–23.

    Google Scholar 

  19. Viterbo F, Amr AH. Secondary procedures in facial reanimation. In: Grotting JC, editor. Reoperative aesthetic & reconstructive plastic surgery. 2nd ed. St. Louis: Quality Medical Publishing, Inc; 2007. p. 859–80.

    Google Scholar 

  20. Reis F. End-to-side neurorrhaphy with direct muscle neurotization and end-to-end neurorrhaphy in the recovery of target muscle. Study in rats. PhD Thesis. Programa de Pós-Graduação em Bases Gerais da Cirurgia, Faculdade de Medicina de Botucatu – UNESP, Botucatu, SP; 1 Mar 2010.

    Google Scholar 

  21. Viterbo F, Ali AMG. End-to-side neurorrhaphy. In: Boyd JB, Jones N, editors. Operative microsurgery. 1st ed. McGraw-Hill Professional. 2014. p. 926–33.

    Google Scholar 

  22. Viterbo F, Trindade JC, Hoshino K, Mazzoni Neto A. Látero-terminal neurorrhaphy without removal of the epineural sheath. Experimental study in rats. São Paulo Med J Rev Paul Med. 1992;110(6):267–75.

    CAS  Google Scholar 

  23. Viterbo F, Trindade JCS, Hoshino K, Mazzoni Neto A. Two end-to-side neurorrhaphies and nerve graft with removal of the epineural sheath: experimental study in rats. Brit J Plast Surg. 1994;47:75–80.

    Article  CAS  Google Scholar 

  24. Viterbo F, Trindade JCS, Hoshino K, Mazzoni NA. End-to-side neurorrhaphy with removal of the epineural sheath. Experimental study in rats. Plast Reconstr Surg. 1994;94:1038–47.

    Article  CAS  Google Scholar 

  25. Viterbo F, Amr AH, Stipp EJ, Reis FJ. End-to-side neurorrhaphy: past, present, and future. Microsurg Suppl Plast Reconst Surg. 2009;124(6):351e–8e.

    Article  Google Scholar 

  26. Brock R, Viterbo F. Anatomia da região frontal. In: Cirurgia estética da região frontal, vol. 1. 1st ed. Rio de Janeiro: Medbook; 2011. p. 3–8.

    Google Scholar 

  27. Fedok FG. The avoidance and management of complications, and revision surgery of the lower face and neck. Clin Plast Surg. 2018;45(4):623–34.

    Article  Google Scholar 

  28. Trepsat F. Volumetric face lifting. Plast Reconstr Surg. 2001;108(5):1358–70.

    Article  CAS  Google Scholar 

  29. Viterbo F. Improved blunt dissectors for greater safety in face lift surgery. Plast Reconstr Surg. 2013;131(5):858e–9e.

    Article  Google Scholar 

  30. Baker DC. Lateral SMASectomy, plication and short scar facelifts: indications and techniques. Clin Plast Surg. 2008;35(4):533–50.

    Article  Google Scholar 

  31. Jacono A, Bryant LM. Extended deep plane facelift incorporating facial retaining ligament release and composite flap shifts to maximize midface, jawline and neck rejuvenation. Clin Plast Surg. 2018;45(4):527–54.

    Article  Google Scholar 

  32. Auersvald A, Auersvald LA. Hemostatic net in rhytidoplasty: an efficient and safe method for preventing hematoma in 405 consecutive patients. Aesthetic Plast Surg. 2014;38(1):1–9.

    Article  Google Scholar 

  33. Maciel FO, Viterbo F, Chinaque LF, Souza BM. Effect of electrical stimulation of the cranial tibial muscle after end-to-side neurorrhaphy of the peroneal nerve in rats. Acta Cir Bras. 2013;28:39–47.

    Article  Google Scholar 

  34. Chan KM, Curran MW, Gordon T. The use of brief post-surgical low frequency electrical stimulation to enhance nerve regeneration in clinical practice. J Physiol. 2016;594(13):3553–9.

    Article  CAS  Google Scholar 

  35. Gordon T. Electrical stimulation to enhance axon regeneration after peripheral nerve injuries in animal models and humans. Neurotherapeutics. 2016;13(2):295–310.

    Article  Google Scholar 

  36. Willand MP, Nguyen MA, Borschel GH, Gordon T. Electrical stimulation to promote peripheral nerve regeneration. Neurorehabil Neural Repair. 2016;30(5):490–6.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fausto Viterbo .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Viterbo, F. (2021). Nerves Injuries During Rhytidoplasty: How to Avoid and Surgical Reparation. In: Avelar, J.M. (eds) Aesthetic Facial Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-57973-9_60

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-57973-9_60

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-57972-2

  • Online ISBN: 978-3-030-57973-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics