Endo Browlift- Sharp Burning/tearing Sensations Near Incisions

Question

Hello, I am 4 weeks post an endoscopic forehead lift. During the 4 weeks I occasionally feel a sharp burning or tearing sensation near 2 of the incisions. Lately it has been more frequent and especially if I try to make any movements that normally would wrinkle my forehead (ie sneezing). My brows/lids are lower than after surgery but still a bit higher. Could sensations be endotine failure as tissue is pulling away? Is it normal for brows to have already dropped? I'm 32 y.o

Lawrence Kass, MD · Answer

I agree with others who responded that this is likely a normal postop finding and will likely improve with time. If the symptoms persist or worsen, it may indicate a problem with the endotine fixation.

Sean T. Lille, MD · Answer

Dear NYC girl,

	Inflammation from the surgery along with nerve entrapment can cause your current problems. I would see your plastic surgeon who will likely place you on some anti-inflammatory medications. He may also suggest a drug that specifically reduces nerve inflammation.  Just be patient. It will heal with time and the appropriate medications. Just stay close to your plastic surgeon who will reassure you along the way.

	Dr. Lille

Kenneth D. Steinsapir, MD · Answer

An endoscopic forehead lift is a procedure that involves a large area. Sensory nerves can be disrupted and lead to a variety of sensations. There can be settling on the endotines which is why I still prefer the metal posts with staples behind them. However, at a month, the forehead is very well healed down so that the type of settling caused by slippage on the endotines is probably past. On the other hand, occasionally the sharp tines subjectively and objectively bother the surrounding tissue which can lead to pain when the forehead muscles contract and in some cases actual skin break down. For this reason, it is necessary to explant a small percentage of these endotines. Generally I attempt to wait until the second or third month before removing these. It can be done as a smallish office procedure under local anesthesia in a well equipped office procedure room.

Steven Wallach, MD · Answer

Some discomfort is normal after surgery, but if you are feeling seering pain and almost a shredding or tearing effect, it may very well be endotine failure.

Philip Young, MD · Answer

This could be the give of the endotine. Also it coiud be from tension on the skin closure. Nerve regeneration could also be issue. Much of this discomfort should begin to get better. Anti inflammatories, steroids can help decrease any inflammation that is occuring. If it is the endotines giving way, a revision could be needed.

	Thanks for reading, Dr Young

Houtan Chaboki, MD · Answer

Hi nycgirl78,

	One month after surgery is still relatively early after plastic surgery, as healing is still occurring. Burning and nerve sensations can occur with any brow lift procedure, including Endoscopic Brow Lift with Endotine implants. These sensation generally resolve with time. Sometimes an antihistamine tablet may relieve some scalp sensations. Alternatively, some patients benefit from local anesthesia injections to help reduce nerve pain or discomfort.

	Lastly, all brow lifts may settle downward a bit after the initial surgery, which is expected. Any potential "slip" of the implant is unlikely at one month after surgery. Speak to your plastic surgeon now to evaluate you and help determine appropriate options. Best of luck.

	Dr. Chaboki

Francis R. Palmer, III, MD (retired) · Answer

Yes, tearing or pain after an endoscopic Brow Lift with fixation could indicate endotine failure and you should see your surgeon for follow and specific recommendations. I still prefer the Coronal Brow Lift that's self contained and does not rely on sutures, threads, hooks or metal bone screws for fixation points that can and do weaken.

Endo Browlift- Sharp Burning/tearing Sensations Near Incisions

Answers (7)