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

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?

Doctor Answers 14

If the nerve was actually cut, it is very unlikely to regenerate.

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. 

Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

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

 To specifically answer the question, you asked.  No, if the temporal branch, of the facial nerve, was cut during your Face Lift the nerve will not regenerate on it's own.  If the nerve was injured, it may recover at 1mm a day from the point of the stretch or injury.  This would mean that somewhere between 3 and 6 months, you would see some movement in the forehead.  If no movement occurs at 1 year, the nerve will most likely not re-grow and the forehead will remain paralyzed on that side.  You should be referred to a neurologist and discuss the success rates for surgical re-attachment of the temporal nerve.  These branches are quite small but perhaps a nerve grafting method (cable graft) has been used in these cases. Hope this helps.

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

Nerve regeneration if cut in face lift?

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!

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 116 reviews

Frontal Branch Paresis

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.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Nerve Injury During a Facelift

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.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 65 reviews

If nerve was cut, surgical repair is needed

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

Kamran Jafri, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Nerve regeneration

If the nerve was totally severed you will have minimal recovery unless it is repaired.  That said it may take several months for a "bruised" nerve to recover.   Give it more time and if no improvement, discuss nerve repair with your surgeon.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 43 reviews

Hard to say...

if a frontal nerve is severed, it is unlikely to regenerate. Most nerve injuries ARE temporary, and you still have a chance of function returning. Nerves regenerate at a very slow rate, about a centimeter a month. So if a nerve is damaged 6 cm from the muscle, it will take six months to recover. You may want to try botox on the non-injured side to improve symmetry while you are waiting. Good luck!

J. Charles Finn, MD
Raleigh-Durham Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Nerve injury after a facelift

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!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 73 reviews

Nerve injury after a lift

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

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.6 out of 5 stars 221 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.