If Nerve Was Cut During a Face Lift, Do I Have a Chance of Nerve Regeneration?

Question

The right eyebrow and right side of forehead got totally paralyzed since a face lift done 10 weeks ago. I don’t know if this is only a nerve damage or if this branch was severed. I am doing therapy with muscle stimulation so the muscle get some activity until the nerve regenerate, if so. I can close my eye normally, the only part that doesn’t move is eyebrow and same side forehead. I would like to know if even if the nerve was really cut during surgery, do I have a chance of nerve regeneration?

Kenneth D. Steinsapir, MD · Answer

Many of these injuries are stretch injuries. The nerve sheath is intact and some degree of recovery can be seen. What was injured was the frontal branch of the right facial nerve. Where your nerve was injured the nerve fibers are actually very fine. It is probably amazing that we do not see more of these injuries. I would say that after about 6 months it is unlikely that recovery will take place. Surgical repairs for nerves this peripheral are not very reliable. Most of the work out there involves placing a patch graft where the injury involves the main nerve trunk on the side of the face.

Sam Naficy, MD, FACS · Answer

I believe you have asked this question before.  As stated by others you need to wait and hope for a full recovery

John J. Corey, MD · Answer

Most likely your nerve was stretched or bruised and should make a full recovery. One thing you might do is a little Botox or Dysport over on the other side to even you out until the nerve wakes back up!!! It works really well for this...

Lawrence Kass, MD · Answer

You have already received much great advice. But no one on this forum can determine if your nerve was cut or just stretched during your recent surgery. But I am writing just to say that the odds are certainly in your favor. Keep doing what you are doing, maintain a positive outlook, and realize that in 6-12 months the odds are good that you will have a complete recovery. Good luck!

David Finkle, MD · Answer

Contained In the face are two types of nerves, sensory and motor.  The sensory nerves supply sensation or feeling to the skin, the motor nerves supply the muscles of face which give us motion and movement.The nerve that was damaged in your procedure is the frontal branch of the facial nerve, which is a motor nerve.  Depending on where the nerve was injured will depend on which muscles are affected and paralyzed.  The closer the injury is to the main trunk of the nerve, in front of your ear, the more muscles are affected.  The farther away from the ear, the facial nerve branches out like tree branches and the fibers become smaller and smaller.  Fewer muscles are affected when the injury is more peripheral.  Your injury is more peripheral.The branch that was injured in your situation is a recognized complication of a facelift procedure, and even though it is not common, it is not uncommon either.  Nerves regenerate very slowly, sometimes taking 9-12 months to regrow.  If your muscle function does not return in that time frame, then the injury is probably permanent.  Be patient and continue the external muscle stimulation to keep the muscles from atrophying in the mean time.Keep in close contact with your surgeon, I'm sure he/she is as worried as you are.Good Luck!

Joseph Hunstad, MD · Answer

The incidence of permanent nerve injury following a facelift is very rare. A facial nerve can regrow for as long as 2 years after surgery and the vast majority of nerve weakness following facelifting is a temporary nerve palsy that represents either bruising, swelling or stretching and is not really a division of the nerve.

Kimberly Lee, MD · Answer

You are describing effects of paresis of the frontal branch of the facial nerve. Usually this is temporary and function with return, but you must be patient as it can take up to a year to recover. In the interim, there are treatments that can be done to achieve symmetry while you wait for the nerve function to return. There are other exercises that you should be doing to help this recover. The good news is that you are able to close your eye. If the function does not return in a year, there are treatments that can help you as well.

Karol A. Gutowski, MD, FACS · Answer

In most cases, the nerve is just stunned and can take 6 to 12 months to improve. Keep working on your therapy and see how things go.

Kamran Jafri, MD · Answer

Hi Maria,

	Just wanted to add on little more information to the excellent answers you have gotten.

	As has been noted if the nerve paralysis is due to nerve swelling, traction (pulling on the nerve) or bruising a partial if not full full recovery of the nerve can be expected with time (this may take up to a year).

	However if the nerve was cut then surgical repair of the nerve is required in most cases. Even with surgery there is a recovery time for the repaired nerve to regain function.

	Continue to follow closely with your surgeon and I agree with the use of Botox to help your brows/forehed look symmetric until further healing occurs.

	Good luck,

	Dr. Kamran Jafri

Brian Klink, MD · Answer

The frontal branch of the facial nerve can be traumatized during a facelift. This can range from a bruise to complete severing. The vast majority are bruised and do return over a period of weeks to months. If the nerve is cut, the nerve will obviously not work and you will be left with permanent brow paralysis. Good Luck

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If Nerve Was Cut During a Face Lift, Do I Have a Chance of Nerve Regeneration?

Answers (14)

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