Can cut nerves be repaired after a bilateral brow lift? I have total numbness from hairline to crown of head.

Question

I had a bilateral brow lift on Oct 28,2013. My surgeon told me that I would have total numbness from hairline back 3 inches. Nerves were cut. Is there any procedure to reconnect nerves?

Thomas Romo, III, MD · Answer

The degree of numbness after brow lift and the probability of sensation returning is mostly determined by the type of brow lift procedure performed. An open approach where the incision is made across the scalp totally cuts the sensory nerves and leaves the area behind it permanently numb. A closed approach, the endoscopic technique, is designed to preserve the sensory nerves. The small incisions and scope allow for more precision and accuracy. With this approach if numbness is present postop, sensation usually returns within six to eight weeks

John J. Martin, Jr., MD · Answer

The supraorbital nerve starts at the brow and goes up to the hairline and then back to the crown of your head.  With either a coronal or pretrichial browlift, the nerve is cut with the dissection.  As you heal, the nerve will regenerate, and sensation will return.  You will often have some strange sensations or tingling as the nerve returns.  It can take at least 6 months for this to occur.  Although less common, you can also get numbness with an endoscopic browlift.  Dissection is usually done right down to the brow, and the inflammation can cause some temporary numbness.

Richard Parfitt, MD · Answer

I'm assuming that, with the total numbness description, that you had what's call a "coronal" brow lift with an incision starting above one ear and extending to the same location above the opposite ear.  With this type of forehead lift, there is always numbness behind (posterior to) the incision line (not starting at the hairline - there should still be full sensation from the hairline to the actual incision line).However, most of this sensation will return over the course of the year following the surgery.  Rarely does it come back completely -- all the way to the incision line -- but it usually returns to within a half inch or so, compared to the three inches you now experience.It is certainly possible to TRY repairing any nerve that has been cut, but it would be quite difficult to find the nerve endings as they are probably less than a tenth of a millimeter in diameter at this level of the scalp -- so it would take microsurgery techniques to accomplish this and the cost for doing so would be astronomical.  Insurance would not cover this.The vast majority of people adjust to the loss of sensation very well.  After all, sensation in this area isn't nearly as important as in other areas of your body.  It can be quite annoying at first -- but my suggestion is to give it time.  It is still pretty early out from the surgery, and you'll be surprised at how much sensation returns and how much you get used to the change in sensation.  In the meantime, the main thing to be cautious of is using a hot curling iron or hair dryer, as you can be overheating or even burning the skin that is numb without realizing it.

Michael R. Menachof, MD · Answer

In an endoscopic brow lift, the nerves are identified and preserved causing occasional temporary numbness due to bruising (not cutting) of the nerves. A coronal brow lift, on the other hand, does cause several nerve branches to be cut, in which case the numbness will be permanent. If your surgeon knows that the nerves were cut, you will always have some numbness in the area and there is nothing that can be done. Over time, small nerve endings can grow in to the periphery of the numb area causing the total area of numbness to get a bit smaller. I hope this has helped.

Sheldon S. Kabaker, MD FACS (retired) · Answer

I know of no surgery that is done for this situation. In all cases I have seen, sensation returned after 6-12 months.

Can cut nerves be repaired after a bilateral brow lift? I have total numbness from hairline to crown of head.

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