My surgeon says to wait, and the movement will return. What could have happened?
inability to lift one eyebrow after either an endoscopic or open forehead lift or brow lift is not uncommon. it is usually due to post-op swelling, stretching, or bruising around the frontal branch of the facial nerve. In most patients the funciton of the frontalis muscle which lifts the brow recovers from two to 9 months. Meanwhile, if this bothers the patient, they can weaken the other side with botox to achieve more symmetry.
Sean Younai, MD, FACS
During the course of a Brow Lift, whether open or endoscopic, there may be stretching of the Frontal Branch of the Facial Nerve, which supplies movement to the forehead muscles. In many cases, this results in a partial or total paralysis of the forehead muscles, either on one or both sides of the forehead, similar to the effect of Botox.
If there has been stretching of the nerve, it is likely that nerve function will return sometime within the first six months after surgery. Until then, it is better to wait for return of function. If the asymmetry of the brow is disconcerting, the "normal" functioning side of the brow can be temporarily paralyzed with Botox while awaiting return of function on the side that is not moving normally after the Brow Lift.
Most neuropraxias of the frontal branch of the facial nerve that controls elevation of the brow are temporary in nature and more recover after a few days. Some last longer and may take up to six months depending on the type of injury (i.e. bruise, stretch, cauterization,crush). As suggested, you can use Botox to even out the deformity as the nerve recovers. If it is a permanent injury and nothing seems to be working after 6-12 onths, you can ablate the oposite nerve to create a symmetrical look.In fact, this is what used to be done in the past as a matter of course in brow lifts, to remove or permanently disable the frontalis muscle. of coure, while it made for an effective and long-lasting brow lift, it produced a completely inanimate appearance of the forehead.
I would wait quite a bit and return to your surgeon to monitor any return of function.
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