Likely Frontal Branch Injury

Scott E. Kasden, MD answers: One brow not moving 1 month after Brow Lift

My surgeon says to wait, and the movement will return. What could have happened?


Scott E. Kasden, MD
10 months ago

Injury to the frontal branch of the facial nerve can result in asymmetrical or non movement of the forehead/brow.  This is a paired nerve and either, both, or neither may be injured.  In the endoscopic technique, the usual injury (in my experience anyway) results from stretching the nerve, rather than cutting it.  As such, the injury is generally not recognized at the time.

I agree with your surgeon on this.  It is best to wait.  It may take up to a year or even longer for return of function.  It usually takes a month before any return is noted, and this is usually a slight flicker of muscle activity, which progresses to significant movement.

There is no quarantee that the function will return however.  If this is the case, you may choose to just leave things alone, or you may want to discuss with your surgeon the option of cutting the other nerve- an old and accepted treatment in this situation.  In the mean time, you may think about botox for the non-affected side to help with symmetry.

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