Nerve damage? I had an endoscopic brow lift and midline facelift and fat transfer to the chin two weeks ago. (photo)

Permanent nerve damage in endoscopic brow surgery and midface surgery is extremely rare because most of the instruments used are elevators which gently push and allow elevation or release of tissues without having to use sharp instruments like scalpels or scissors in the areas where nerves are present. Bruised nerves or muscles can sometimes take several months to improve, but it is very unlikely that anything nerve was cut during your surgery. Sometimes gentle pressure during the elevation process will bruise the nerve and I would suggest to you this is much more likely. There are special test (EMG) which can determine if a nerve was cut, but it is early even for this.

One of the reasons endoscopic brow lift is utilized is because of the safety factor around the nerve branches. The nerve is rarely cut but it can be pulled and stretched. This can cause temporary loss of function but usually comes back in several months. If your appearance bothers you right now, a neuromodulator like Dyport, Botox or Xeomen can be used to bring the elevated side down.

First of all, I'm curious about how long ago your surgery was. The farther out from surgery without ANY improvement, the more concerning muscle paralysis is.There can be weakness of the forehead muscles following either facelift or forehead lift, but my experience is that so long as there is even a little movement in an area of concern, then the nerve is just "stunned", either by a tight suture or mild injury from a cautery injury, and that full funciton will return if this is the case, and usually occurs within 2 to 4 weeksHowever, if there is total weakness with no improvement over at least a 2 week period, then it's possible that a nerve to the forehead muscles was severed. Again, this can happen with either a facelift or forehead lift procedure. If the nerve is severed, then full muscle function will not come back. I'm honestly not sure what can be done to repair a severed nerve to the forehead, as this has never happened in my practice. I have heard of surgeons using botox on the good side in order to paralyze that side as well, which should result in better symmetry.In any case, keep in close contact with your surgeon as he/she will probably research thoroughly what to do if there has been no improvement for a prolonged period.

Since you are only a couple weeks from surgery it should return to a normal function. It may be months before it comes back though. It most likely is what we call a Neuropraxia. This simply means the nerve was "bumped" into and stopped working. After about a month delay it should start to "heal" but it still could take up to 6 to 12 months for the function to come back. There is an outside chance it would not return but in my experience it always came back.