Can I expect to regain control of forehead muscles after laceration down to the bone? Do I need plastic surgery? (Photo)

I was in a car accident 6 days ago. I had a laceration to my forehead that required 3 internal stitiches for the muscle and 24 external stitches along with 3 staples. I am able to blink that eye and control my lower eye lid/cheek but my forehead has no movement on that side and is a little droopy. I know it's too soon to see improvements of the damaged muscle but I'm wondering if I should ever expect it to function normally or should I prepare myself for the need of plastic surgery to lift my eyebrow.

Doctor Answers 3

Regaining Forhead Motion: Time Will Tell

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I am very sorry about your recent accident.  The location of this extensive laceration is in the vicinity of the path of the frontal branches of the facial nerve.  This may or may not have lead to transection of these branches.  It will take 12-18 months to make a full determination.  However, if you see any recovery of function in the first 6 weeks to 3 months, it is a very good prognostic sign.  If no recovery of function is noted, a surgical browlift can be utilized.   In the meantime, application of a neurotoxin such as Botox to the opposite side will help minimize the asymmetry. 

Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Laceration to forehead

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I'm sorry to hear about your accident.  Thankfully you have full function of your eye!  Hopefully you had a good repair to your laceration and you are well on your way to recovery.  The laceration certainly looks like it crosses paths in the vicinity of where the frontal branch of the facial nerve travels to provide movement to the frontalis muscle of the forehead.  It's possible that nerve function may return if the nerve were not severely injured -- it can take up to 18 months to see return of function depending on the type of nerve injury.  In the meantime, you can get some Botox or Dysport to the opposite side of your forehead to balance things out.  While that will lower the opposite side, symmetry will be better.  Later down the road, you can get a brow lifting procedure should nerve function not return and you are displeased with the appearance or are not satisfied with the Botox/ Dysport.  Good luck moving forward.  A board certified facial plastic surgeon can help you with this.  

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

Forehead trauma

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I hate to hear about what happened to you.  Glad to hear you are doing well and they were able to repair things in the emergency department.  At this time, it is too early to tell.  It is likely that the nerve was injured, based on the picture you sent and what you are seeing now clinically.  Best prognostic indicators for nerve regaining function are age as well as degree of functional loss (this is all assuming that there was no transection).  This can all be assessed by a reconstructive or facial plastic surgeon with an exam.  It is a long road to recovery, and to be honest, I know you are concerned about the asymmetry in your brow, but at this point I would follow up for suture removal and see a specialist who will be able to better guide you after physical exam, etc.  I wish you the best.

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 20 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.