Q: Dr. Eppley, I had paranasal implants placed last week. About how long will it take before my smile looks normal? And how long should I wait to attempt to smile? Also, I can feel a hard knot like object on the left side about less then 1/2 an inch below my inner corner of my left eye next to my nose. What is that? Is that the paranasal implant. I thought paranasals was supposed to be on the side of my nostrils but I can feel this bulky area below my eyes right alongside my nose way up high. The bulky area extends down to the middle of the side of my nose. I feel it and see it on both sides but it is bulkier, harder, higher and more obvious on the left. I attached a pic of my swelling progress. Sorry but I’m not so pretty.l My lips nose cheeks are all numb and I keep getting strange shooting pains on the left side of my face. Sometimes they startle me bad.
A: The general rule on any facial structural change, such as paranasal implants, is that 50% of the result will be evident by three weeks, 75% by 6 weeks and the full result by three months after surgery. Therefore, any issues related to the way it looks or feels must go through these time periods. What one sees and feels at one week after surgery will likely change or become irrelevant in another month. Swelling, fluids and tissue shrinkage take time just as it did for your rhinoplasty. When it comes to functional recovery after facial structural surgery it has a similar time course although usually much faster. Nornmal feeling and mouth movement will take 4 to 6 weeks until things are nearly normal. Paranasal implants are very much like cheek implants, they are placed around the large infraorbital nerve which supplies feeling to the side of the nose and the upper lip. (and is actually the nerve the dentist injects with local anesthetic when working on your upper teeth which is why it feels similar) By working around this nerve it is normal that it will go numb for awhile after surgery and takes some time to get its feeling back. As the nerve recovers from being stretched it will have many strange feelings including shooting pains or shocks. This is how the nerve recovers somewhat similar to when your foot goes asleep and feeling comes back into it.
Thus, being just one week out from surgery everything that you are experiencing is perfectly normal and expected. If this were two months out from surgery it would be a different story. But this is still early in the process and the only thing you can do at this point is let healing takes its natural, albeit long for you, course. You should smile and move your mouth as you feel comfortable. What you feel up high in the side of your nose is not the implant (as that would be impossible) but swelling.
Dr. Barry Eppley