Facial Trauma and Nerve Damage: Recognizing Subtle Signs After Injury

Facial injuries do more than bruise the skin. They can disturb the delicate nerve pathways that animate your smile, blink, and speech, sometimes in subtle ways that are easy to miss immediately after an accident. At the Hadlock Center for Facial Plastic Surgery, Dr. Tessa Hadlock helps patients recognize and address these early issues with expertise and compassion. Here’s how to spot the quiet warning signs, what to do next, and how evidence-based treatment restores natural expression.

Early Red Flags You Might Miss

Not all nerve injuries are obvious on day one. Swelling, bruising, or pain can mask early dysfunction. Watch for changes that persist or progress after the first few days.

• Eye symptoms: Incomplete blink, frequent tearing, light sensitivity, or a dry, irritated eye that worsens as fatigue sets in.
• Smile symmetry: A flatter smile on one side, crooked dimples, or upper lip that does not lift evenly when you show your teeth.
• Subtle speech shifts: Words that feel harder to articulate, air escaping at the corner of the mouth, or lip fatigue with longer conversations.
• Cheek and lip control: Food pocketing in the cheek, difficulty sipping through a straw, or dribbling liquids from one corner.
• Unwanted co-movements: Eyelid narrowing when you smile or mouth pulling when you blink, a sign of synkinesis as nerves heal.

The First 72 Hours: Steps That Protect Function

The first three days after injury are critical for protecting facial function. Key steps include:

• Documentation: Take clear photos or a short video of relaxed and expressive movements to track changes.
• Rest and protection: Keep your head elevated, rest the face, and use preservative-free eye drops by day with ointment at night if eyelid closure is weak.
• Avoid strain: Refrain from heavy exertion or facial exercises until evaluated.
• Specialist evaluation: If you notice weakness, asymmetry, or eye irritation, contact a facial nerve specialist promptly.
• Early follow-up: Communicate regularly with your care team to help guide recovery and prevent long-term complications.

How We Tell Swelling From Nerve Injury

At the Hadlock Center, your exam focuses on both appearance and performance. We map individual muscle groups, assess eyelid closure and corneal protection, and observe for early synkinesis. When appropriate, we support the assessment with targeted imaging and testing. Clear documentation informs treatment decisions and provides a reference as healing unfolds.

Treatment Pathways Tailored to Your Injury

Every treatment plan is guided by safety, timing, and the goal of restoring natural expression. Drawing on decades of experience in facial reanimation, Dr. Hadlock and her team use advanced microsurgical and rehabilitative techniques to help patients recover movement, symmetry, and confidence.

• Facial nerve repair: Precise microsurgical techniques to reconnect or restore function when the facial nerve has been damaged.
• Nerve grafting: Using a healthy donor nerve to bridge a gap when direct repair is not possible.
• Static suspension and support: Procedures that lift and stabilize facial features to improve symmetry and comfort.
• Facial retraining and therapy: Customized physical therapy programs to rebuild strength, coordination, and control after trauma.
• Injectables for balance: Targeted use of neuromodulators or fillers to refine facial movement and appearance during recovery.

Ready For An Expert Evaluation

If you have experienced facial trauma and notice even small changes in blink, smile, or speech, early guidance can make a lasting difference. Schedule a consultation with the Hadlock Center for Facial Plastic Surgery to meet Dr. Hadlock, Harvard Medical School Professor and dual board-certified facial plastic surgeon. Our team will listen carefully, examine the details, and develop a plan that balances both function and aesthetics. Heal with confidence, and return to the expressions that feel like you.