I Had a Facelift 7 Months Ago and my Eyebrow is Still Frozen. What Are my Options?

   A frozen eyebrow after facelift may continue to improve for 18 months or 2 years.  Kenneth Hughes, MD Los Angeles, CA

Thanks for the question. First 24-48 hours after the operation face will be swelling. After 48 hours swelling will be decreases. Scalp area stitches are taken from the day 10. Final results may take 1 month. Patients can return to work after 1 week. The effect of gravity varies according to the aging speed and lifestyle but it provides an average permanent effect of 10 years. I wish you all the best.

One of the most serious complications from Facial Surgery is injury to the nerves that control the facial muscle. The branch of the facial nerve that controls the forehead is known to be at risk, although it is still a very rare occurrence. If no degree of strength returns to the nerve over 6-12 months, it is likely that the injury is permanent. There are nerve repair surgeries that can be performed, with varying degrees of success even in the best hands. In most cases, a Browlift procedure can keep the eyebrow from drooping, but since the muscle of the forehead may still not work, Botox or Dysport can be used to treat the other side of the forehead to keep the level of movement more equal across the forehead.

At 7 months, a damaged nerve should be showing signs of functional return.  The patient needs and evaluation.  Hope is not lost but it's time to start worrying.  Contralateral Botox can offer temporary symmetry but the frontal branch of the facial nerve might require repair.

Since nerve function can return as late as 12-18 months after the initial injury, It would be wise to continue to wait prior to embarking on surgical correction.  However, in the meantime, Botox/Dysport treatment to the opposite side can be of some help.  Also, judicious use of fillers to the area around the eyebrow can provide a small amount of eyebrow elevation, which can further help with symmetry and will not affect the nerve's recovery.  Good luck, and I wish you a speedy recovery!

It is possible, at this point, that brow movement might not return on that side. It is not unheard of for movement to return at 12 months or even later but that is uncommon. Your options include using Botox to soften the movement of the normal side vs. having a browlift procedure to lift and reposition both eyebrows to provide more symmetry. I hope this information is helpful.Stephen Weber MD, FACS

You have likely had an injury to the frontal branch of the facial nerve on that side.  At this stage, it is unlike, but there is still a slight possibility that it may recovery function.  There are several options to help improve the appearance including, but not limited to, using Botox or Dysport to create "paralysis" of the good frontal is muscle to make both sides not move, do a brow lift on the affected side, or even re-explore that injured side and see if the nerve branch can be repaired.  This would require a plastic surgeon with expertise in microsurgery.

With inadvertent injury to the frontal branch of the facial nerve, the eyebrow will not raise. While it is impossible to say that it will never recover, more than half a year from surgery with no movement is not encouraging. If there is no hint of movement by a year after the procedure, then it recovery is not going to occur. Depending upon the brow position with paralysis, a browlift procedure may be considered in the future on that side.

By frozen we presume you are unable to lift the eyebrow on one side after your facelift. Facial nerve injury is uncommon during facelift these days, though after the auricular nerve, the frontal branch of the facial nerve to the forehead is up on the injury list. The nerve is fine and most often has few 'cross connections' as seen in other facial nerve branches so recovery after seven months is iffy, but the best option is to wait out a full year.

You are describing a probable injury to one or more branches of the facial motor nerve that supplies the forehead muscles, the frontal branch. This is uncommon with current facelift techniques, but recovery may well occur up to 1 year after injury. This area is actually supplied by several separate branches, and therefore some recovery, if not total recovery, usually is evident by then. Alternative options include Botox or Dysport to the opposite side for symmetry, and browlift for drooping if no eventual recovery. Good luck!