One Eyebrow Still Paralyzed 9 Months After Coronal Brow Lift. Options?

Hello,

  I know it is not easy to wait, but patience is paramount with any suspected nerve injury.  Permanent nerve injury is uncommon following a brow lift, and the fact that you are witnessing slight movement is a very promising sign. 

As part of our training, facial plastic surgeons perform dozens of procedures removing cancers from the head and neck.  During removal of the tumor it is very common to lift a nerve out of the way, stretch it, look at it wrong, virtually any manipulation of a facial nerve will cause it to stop working after surgery.  During cases of temporary weakness, the recovery is slow and happens over the course of 12-18 months.  If there is still inadequate function at 18 months I would advise you to consult with another surgeon.  There may be a way to improve symmetry between the two sides, and your feelings about a corrective procedure may change.

 

Such nerve injuries do occur but are fortunately uncommon.  It is possible that you will continue to get function back for up to 2 years.

Yes, the fact that you have some slight movement of a portion of the forehead is a positive sign - it means that some signals are getting through.  Hopefully, with more time, more nerve function will recover, and your situation will improve.  Nerve recovery is a slow business, though.

the fact that your brow is moving is a good sign of return..  botox on the other side is still a good option till they are equal..  if it doesn t improve.. you can consider weakening the nerve on the other side

Nerve injury after brow lift is a know complication.  The fact that movement is present is a good sign meaning it was not cut.  In spite of this, it was injured during the surgery.  You must give it more time and after a year to a year and a half, it will probably be permanent.  Botox as you stated will help but temporary. 

 

I hope this helps.

The fact that you've gotten some function back is a good sign. It may just take more time to get more function though it may not all come bak. It could certainly take up to a year. You should exercise your forehead by trying to lift your eyebrow. Frequently during the day. Hopefully it will encourage further nerve return. Be careful about the botox on the other side. While it may make them look more even, you just don't want to get the Botox to spread into the affected side since this would stop the signals for the nerves to recover and grow back where you want them.

Injury to the frontal branch of the facial nerve is associated with a slow recovery due to its lack of any cross-innervation. At nine months after surgery, it sounds like you have had a minimal recovery of its function. It is still possible that more nerve function will return and all hope is not lost until you are up to two years after surgery. There are no surgical or non-surgical methods that can assure or speed up recovery of this facial nerve

It sounds like you may have some early recovery of the nerve. Give it a few more months to see if it gets back to normal.

Forehead paralysis secondary to a brow lift is a very rare complication. It is encouraging that some movement is present. Wait another year to see if there is more improvement. There is nothing you can do to improve or speed up recovery. Botox will help in the interim.