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One Brow Not Moving 1 Month After Brow Lift

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

Asked 39 months ago by humbird in us
Sort 29 expert answers by:
+1

One Brow Not Moving 1 Month After Brow Lift

The first thing I would tell you is to wait and be patient.  Most of these get better by 6 months.  During surgery there was manipulation of the tissue around the nerve that allows you to lift the brow and after surgery there is swelling.  These conditions, plus others, result in temporary paralysis of the brow.  It is rare to have permanent nerve damage.  
Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
+2

Brow Not Moving After Browlift

It is most appropriate to give yourself more time to see if the brow motion returns. I have had many patients who have seen the return to normal over 3-6 months or longer. It is possible that the motion will not return. You may choose to have a nerve conduction study to help evaluate the condition of the nerve or begin nerve stimulation to try to hasten recovery.
Paul C. Zwiebel, MD
Denver Plastic Surgeon
+2

Frontal branch injury typically temporary following Brow Lift

The dissection and movement of the tissues required to elevate the forehead and eyebrows during endocopic brow lift surgery can cause dysfunction of the frontal branch of the facial nerve, which innervates the frontalis muscle. This would lead to decreased function of this muscle. Fortunately, unless the nerve was actually severed during surgery (which is rare), its function should return over time, although it can actually take quite a while for some folks. For the most part, just hang in... more
David M. Mills, MD
Pensacola Oculoplastic Surgeon
+2

Correction of weakened brow movement after browlift varies on surgery performed

This can be caused by mechanical intereference with the muscle or nerve. You did not specify the type of procedure Generally recovery of nerve function is to be expected in most cases of brow lift but it depends on the technique Transblepharoplasty brow lift (through the eyelid) Direct brow lift (excising skin above the eyebrow) Pretrichal Brow/Forehead Lift (in front of the hairline) Endobrow lift (Forhead lift using endoscopic techniques ) Coronal brow lift (incision across the scalp from... more
Otto Joseph Placik, MD
Chicago Plastic Surgeon
+2

This should get better

Temporary weakness of the forehead muscles after a browlift is not uncommon. There are several possible causes. The nerve that causes movement of the brow runs very close to a vein that frequently needs to be cauterized. This can cause some heat transfer to the nerve that may prevent it from working properly. Also, the surgery itself can cause a direct injury to the nerve by stretching it. These types of injuries typically heal within 2-3 months and complete recovery of the movement is... more
Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
+2

It takes time, but almost always the nerves start working just fine.

Humbird, During brow lift, the nerves are stretched as the skin is pulled. This leads to a transient neuropraxia (weakened nerves) which may occur on both sides or only one side. It is impossible to predict who this will happen to prior to surgery. The good news is that almost always the nerves start working just fine. The bad news is that it may take 1 to 3 months to recover full function. In the mean time, you may be able to have Botox injected under the brow to help lift it... more
David Shafer, MD
New York Plastic Surgeon
+2

Keep the faith

Nerve bruising and/or stretching may occur during a brow lift operation. This may temporarily injure the nerve that causes your brow to move. In the overwhelming majority of patients the nerve function returns to normal, but the recovery may take six months. Have patience, trust in your surgeon. If it is disfiguring at this point you can consider temporarily paralyzing the other side with Botox for symmetry until the injured side returns to function. Good luck!
Kenneth R. Francis, MD
Manhattan Plastic Surgeon
+1

Frozen eyebrow after browlift

Occasionally patients will experience temporary eyebrow asymmetry after an endoscopic(non-invasive) or coronal (open) browlift.  This brow asymmetry is due to lack of elevation of the affected eyebrow, with that brow appearing lower than the opposite unaffected side.  Occasionally the nerve that elevates the eyebrow can be stretched or bruised during surgery, resulting in weakness and lack of elevation  that usually returns within 6 months.  Uncommonly it can be cut... more
Daniel Shapiro, MD
Scottsdale Plastic Surgeon
+1

Brow Lift and Forehead Motion

During a brow lift the nerve that activates the forehead muscles is at risk of injury.  The nerve is at very low risk of being cut as the surgery should not expose the nerve, but it is at high risk of being stretched.  A stretched nerve will recover in time.  This time can be as long as 6 months but is usually much less.  There is no treatment but to be patient.  You may consider putting some Botox in the other side of your forehead to weaken that nerve... more
Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
+1

Frozen brow after browlift

One of the main anatomic concerns during a brow lift procedure is protecting the nerve that allows your brow to move up and down (the frontal branch of the facial nerve). Although actual permanent injury to the nerve is quite rare in experienced hands, it is not that uncommon to have transient, short-term weakness of the brow muscle  --possibly due to the nerve being irritated (stretched, etc.) during surgery. The good news is that the vast majority of these cases end up with a full... more
Haresh Yalamanchili, MD
Houston Facial Plastic Surgeon
+1

Nerve injury after a Browlift

When doing a brow lift you get very close to a nerve branch of the Facial Nerve (frontal branch- the branch that raises the eyebrow)  that runs near the outside edge of the brow.  Unfortunately, there is a blood vessel that runs very close to the nerve branch.  When cauterizing the blood vessel, that nerve is at risk of both temporary or even permanent damage.  At one month you are still way to early to see nerve function return if the loss is temporary.  It... more
John Bitner, MD
Salt Lake City Facial Plastic Surgeon
+1

Nerve injury after brow lift

It is possible to have temporary paralysis of some of the facial muscles after facial surgery, including brow lift, where the nerve that raises the brow may be injured. Most often, allowing the nerve to recover will correct any asymmetry, and this may take several months.
Olivia Hutchinson, MD
New York Plastic Surgeon
+1

Brow weakness after browlift

The nerve that raises the eyebrow - the temporal branch of the facial nerve - is the most commonly injured motor (motion) nerve during browlift surgery. Fortunately, full recovery over 6-12 weeks is the rule.  Good luck!
Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
+1

Forehead Motion after Browlift

The "power cable" to the brow is the frontal branch of the facial nerve and it is potentially at risk for injury during a brow lift.  Most injuries are related to traction and temporary with function returning from 6 weeks to 6 months.  The best advice I can give you is have a frank discussion and close follow up with your Surgeon.  The asymmetry in motion can be countered with Botox until the affected side begins moving again.
Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
+1

No movement after Brow Lift needs time

Two points: 1. After a brow lift there can be swelling and stunning of the nerve that controls brow movement. Function can return in time and it is just a waiting game. I would give it 6 months atleast. 2. There is a nerve that controls brow movement which is a branch of the facial nerve. Depending on the type of brow lift that you had, there is a possibility that this nerve has been damaged. However, it is very uncommon thought a small risk of the procedure and you would still... more
Chris Thiagarajah, MD
Washington DC Oculoplastic Surgeon
+1

Give brow time to recover motion after brow lift.

Weakness of one or both brows is not unusual due to stretching and swelling around the frontal nerves. It may take up to six months for motion to return after a brow lift. If significant asymmetry is present, Botox can be used on the side that is moving to settle it down and allow the other side to catch up.
Adam Hamawy, MD
Westchester Plastic Surgeon
+1

One brow not moving after browlift

Bruised nerves or muscle under the skin may temporarily be asleep for several months after a browlift. The one that moves can be quieted for a while with Botox. Just give it time. Ask your doctor to help.
Randy J. Buckspan, MD
Austin Plastic Surgeon
+1

Immobile brow after brow lift

This type of injury will typically correct itself over 3-6 months.  If the asymmetry is a big concern in the meantime Botox can be used to improve this.
Sam Naficy, MD
Seattle Facial Plastic Surgeon
+1

Asymmetrical brow after a brow lift

Brow lifts are an effective and popular way to reposition the brow. If you have some asymmetry after a brow lift, it is possible that one of the nerves on one side of your brow may have been bruised or stretched. The symptom should resolve in several months when this nerve repairs itself. At this time, it is too early to perform any corrective procedure.  
B. Pat Pazmino, MD
Miami Plastic Surgeon
+1

This can be a common occurance after brow lift surgery

The nerves that innervate your eyebrow are very sensitive to pressure and stretching which can make them weaker for a time after a browlift. This happens to a lot of surgeons. Sometimes the muscles themselves can suffer trauma that makes them weaker. Time is important. It could take up to 6 months or more for it to come back. The longer it takes, the greater the possibility of weakness in the nerve and muscle. I'm confident that it will come back though. Your body does amazing things. I... more
Philip Young, MD
Bellevue Facial Plastic Surgeon
+1

No movement after brow lift? Give it time...

With respect to one eyebrow not moving after a browlift, this has to do with bruising, stretching or severing of the frontal branch of the facial nerve. This is the longest branch of the facial nerve and takes the longest to return for functioning. There is also a chance that it may never return. Botox is the good interim measure that can be performed to the opposite side so as to decrease the asymmetry on the forehead. The lack of brow movement may take six months to a year to finally... more
William Portuese, MD
Seattle Facial Plastic Surgeon
+1

Likely Frontal Branch Injury

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... more
Scott E. Kasden, MD
Dallas Plastic Surgeon
+1

Usually temporary !!

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
S. Sean Younai, MD
Beverly Hills Plastic Surgeon
+1

You have to play the waiting game, unfortunately

It sounds as if some type of injury occured to the frontalis branch of your facial nerve. In the vast majority of cases the nerve is only stretched and stunned. Over time the function will recover. Seeing a physical therapist skilled in nerve injury rehab might help you take control of your own process better especially if this is just a temporary, albeit irritating, phenomenon. It may take weeks to months to see the return. If the nerve was cut, that is more of a problem. The success... more
Manish H. Shah, MD
Denver Plastic Surgeon
+1

May have a bruised nerve

Sometimes after a browlift, the nerves that innervate the frontalis muscles are stretched a bit.  Usually this gets better over time., most of the time this improves over the first 6-12 weeks.  If the nerve wasacutally cut, then it will not get better. 
Steven Wallach, MD
Manhattan Plastic Surgeon
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