Eyebrow Disaster After Coronal Brow Lift

Had coronal brow lift, face lift, and lower blepharoplasty 4.5 mo.ago. Left eyebrow is 1”lower than right and left doesn't move. Lift left brow &right brow lowers slightly like a see-saw. Is nerve still attached? Did surgeon cut the frontal branch of the facial nerve? Is it damaged or stretched? How can I or neurologist tell? Can I do anything but wait? Surgeon guessing that Ticron braided sutures failed, but no idea what to do. Eyebrow looks awful.Have lost faith in doctor. Can send pictures.

Doctor Answers 10

Eyebrow disaster after coronal lift

  One inch is certainly a lot of asymmetry and 4.5 months demonstrates reasonable patience on your part.  Consider seeing a neurologist for EMG or nerve conduction studies.  These studies will not fix your problem but they may be worthwhile in reassuring you that your nerve will likely recover 12-18 months after the surgery.  Good luck!

Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 131 reviews

There can be asymmetry after surgery

There can be asymmetry after surgery which can often be corrected after approximately 6 months.  Cutting the frontal branch of the facial nerve would cause a palsy so it doesn’t sound like this is the case.  Braded sutures are unreliable.  So, if one of the sutures failed, it may be necessary to try to remove it.  Some doctors will try to put in another suture, but in general I like to stay away from braded sutures.  They are unreliable and once they fail, they are difficult to remove.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

Have it checked out

When one side doesn't move, it almost always indicates an injury to the frontal branch of the facial nerve. If it is stretched or bruised in some way, you will get full function back.  If it is cut, there is very little to do. I would see a neurologist who can do a nerve conduction study to determine the status of the nerve.

Recovery of nerves can take many months.  Be patient.

If it is cut, wait a year to see if yu get back any function.  If not function, you could have the bad side lifted again, or you could cut the nerve of the other side to get symmetry

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon
4.2 out of 5 stars 12 reviews

Brows asymmetric with limited movement after Brow Lift

 Brow Lifts can place the temporal branch of the facial nerve (that lifts the eyebrows) in jeopardy however, this is a very rare occurence.  The nerve function has 1-2 years to return and you can have the eyebrow position adjusted with Botox while awaiting return of nerve function.  You may wish to discuss this with your surgeon and ask for a referral to a neurologist to discuss facial exercise  and nerve stimulation.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Eyebrow Disaster After Coronal Brow Lift

Please post photo in differing facial/forehead actions to demonstrate the differences. But sounds like a facial frontal nerve injury. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Brow lift problem

It sounds like the left brow is paralyzed (or at least weak).  It can take up to a year for the nerve function to come back, so it is best to wait until before considering any surgery.  In the meantime, you can consider botox to the other side for better symmetry.  If the function doesn't come back, then there are surgical options to help improve the symmetry.

Dr Taban

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Brow lift asymmetry

you describe a nerve problem. as you suspected, there is no definitive way to tell at this point. It would be nice if you could describe some flicker of movement signifying early recovery.  if it does not recover there are definitely options to achieve symmetry.  botox in the short term is a must to keep you sane. I am sure your surgeon would be happy to do it for you, on the non-paralyzed side of course, just be aware your brows will be low. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

Coronal forehead lift and paralyzed nerve.

Coronal forehead lift and paralyzed nerve can happen. The eyebrow position can be modified and the paralyzed brow may still return some function. If no return in 3 more months, it probably won't return.

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

Suspect Nerve Injury

The situation you describe is worrisome for a frontal branch nerve injury. Nerve function may continue to improve for up to 6 months, but you are approaching that point. Your best option is to get a second opinion. The active brow can be temporarily improved with Botox, but I suspect you will need a more definitive surgical procedure. Good Luck.

Brian Klink, MD
Vacaville Plastic Surgeon
5.0 out of 5 stars 94 reviews

Possible Nerve Injury

Certainly injury to the forehead branch of the Facial Nerve occurs as a complication of any type of Brow or Forehead lift.  Most of the time the weakness is temporary and function returns in just 2-3 months.  However 5 months is a bit more concerning, but at least partial return of function is still likely.  The decreased elevation of one of the brows is directly due to the nerve dysfunction .  Botox above the active brow may be short term solution to provide better symmetry  until function returns.  Hang in there as usually these problems tend to resolve in time.  Certainly pictures are always helpful in giving the proper advice.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.9 out of 5 stars 18 reviews

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