Concerns After Brow Lift, Midface Lift, and Eyelid Surgery

I am a 37-year-old male in pretty decent shape. It is my 24th day post-op from an endoscopic Brow Lift / Midface Lift (I have 4 incisions in my hairline). The doctor pulled/tightened my droopy cheeks and put some fat injections at the cheek bone. I also had upper and lower Blepharoplasty. He only removed the fat from under my eyes (bags), no cuts on lower eyelids.

One side of my eyebrows doesn’t move at all, and the other I can begin to detect SOME movement. The night of surgery, I had a small emergency due to a hematoma needing cauterized on one side of the hairline area (the eyebrow movement problem side). I had to go back into surgery that night to stop the hematoma in my forehead. He drained most of the blood. That part was a horrific experience.

I felt a lot of blood was left in the forehead. It still feels squishy and swollen. Also, my forehead stitches still have not dissolved and there a couple of serious holes/depressions in the hairline where he did the work on both sides. They are still a little painful. I don’t brush my hair there yet. It feels so weird. It is still numb on top of my head; I still feel some tingling in the brow area too. I feel like I need to go see a neurologist just to know what is going on up there.

Will I ever have my eyebrow movement back on that side? I have read that it could be permanent and it is a rare complication. Will the swelling go down more in my forehead? It seems so slow and inflated. Will the holes in my hairline smooth over? When will stitches dissolve?

Doctor Answers 5

The hematoma and the forehead weakness may or may not be related

Dear GRod

Hematomas happen. A Hematoma is a collection of blood under skin. There is often significant bruising associated with the process as well. It is a risk of having any surgery. They can profoundly delay healing so your doctor did the right thing and acted to control the hematoma.

So it is not surprising that your healing process is sputter along. You will get there but it takes much longer under these circumstances.

The muscle paralysis you are describing can be permanent if the nerves were damaged during surgery. However, the bruising and swelling associated with the hematoma can be associated with motor nerve dysfunction that slowly resolved as the swelling goes down. This can take place over several months. However, in my experience, whatever function has not returned in 6 months represents a permanent deficit. With the forehead lift these types of motor deficits can be relatively subtle even if the weakness does not recover.

As noted by others, some degree of hair root shock is common around the incisions used for the forehead lift. Typically, the hair begins to regrow at these sites after a few months. I have never had a person require scar revision for one of these incisions. Over time they tend to do quite well.

Honestly, I am not sure that seeing the neurologist will do you a bit of good. Mostly, you need time to heal. Three weeks is a very short time frame.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Most likely, all of your concerns will improve with time


Most of the effects you are describing are likely due to swelling and are not that uncommon after surgery. Eyebrow movement and numbness in the scalp and forehead usually recovers over a few weeks to months. I recommend that you address your concerns with your surgeon as he/she will have the best information about your recovery.

Jason D. Meier, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Time will likely help all your concerms

It is early to tell if any of the changes you describe are permanent, but to put you at ease MOST ARE NOT. Muscle weakness recovers in the majority of patients, but may take weeks to months. A little blood under the skin will also go away with time as well.
As for your hairline. The hair follicles are often "shocked" by and incision in the scalp and may take a few months to recover as well.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 126 reviews

Please continue to follow with your Surgeon

Hello G Rod,

Sorry to hear about your post operative experiences. The best advice any of us could give you without the benefit of directly examining you and knowing exactly what was done during your procedures would be for you to continue to closely follow with your Surgeon.

Based on what information you have provided much of what you are experiencing can occur as part of the normal postop healing process as well as related to the hematoma and swelling you have experienced.

Often times patients feel like they don't want to "bother' their Surgeon - this is never the case, so please do follow with and ask all the questions you want of your Surgeon. Sometimes patients feel like they haven't gotten a satisfactory answer to their concerns - even this should never be the case - let your Surgeon know what you are thinking and feeling and I am sure they will be able to guide you through this stressful time for you.

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

It depends on what was done.

 Usually the swelling takes a few weeks to go down after a hematoma. The dents will go away. Usually the forehead paralysis will resolve in several weeks to months.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.