One Brow Not Moving 1 Month After Brow Lift

My surgeon says to wait, and the movement will return. What could have happened?

Doctor Answers 32

Frontal branch injury typically temporary following Brow Lift

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The dissection and movement of the tissues required to elevate the forehead and eyebrows during endocopic brow lift surgery can cause dysfunction of the frontal branch of the facial nerve, which innervates the frontalis muscle. This would lead to decreased function of this muscle.

Fortunately, unless the nerve was actually severed during surgery (which is rare), its function should return over time, although it can actually take quite a while for some folks. For the most part, just hang in there, and you have a good chance of regaining some if not all function.

Pensacola Oculoplastic Surgeon

Correction of weakened brow movement after browlift varies on surgery performed

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This can be caused by mechanical intereference with the muscle or nerve.

You did not specify the type of procedure

Generally recovery of nerve function is to be expected in most cases of brow lift but it depends on the technique

  1. Transblepharoplasty brow lift (through the eyelid)
  2. Direct brow lift (excising skin above the eyebrow)
  3. Pretrichal Brow/Forehead Lift (in front of the hairline)
  4. Endobrow lift (Forhead lift using endoscopic techniques )
  5. Coronal brow lift (incision across the scalp from ear to ear)
  6. Contour thread or suture suspension (thread style lift)

Depeding on what technique was used the nerve or muscles can be exposed to differing amounts of injury and will recover over different time periods.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

It takes time, but almost always the nerves start working just fine.

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During brow lift, the nerves are stretched as the skin is pulled. This leads to a transient neuropraxia (weakened nerves) which may occur on both sides or only one side. It is impossible to predict who this will happen to prior to surgery. The good news is that almost always the nerves start working just fine. The bad news is that it may take 1 to 3 months to recover full function. In the mean time, you may be able to have Botox injected under the brow to help lift it temporarily. By the time the Botox wears off, your brow should be working again.

I hope this is helpful.

Dr. David Shafer
Shafer Plastic Surgery
New York City

Brow Not Moving After Browlift

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It is most appropriate to give yourself more time to see if the brow motion returns.

I have had many patients who have seen the return to normal over 3-6 months or longer.

It is possible that the motion will not return.

You may choose to have a nerve conduction study to help evaluate the condition of the nerve or begin nerve stimulation to try to hasten recovery.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

This should get better

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Temporary weakness of the forehead muscles after a browlift is not uncommon. There are several possible causes. The nerve that causes movement of the brow runs very close to a vein that frequently needs to be cauterized. This can cause some heat transfer to the nerve that may prevent it from working properly.
Also, the surgery itself can cause a direct injury to the nerve by stretching it. These types of injuries typically heal within 2-3 months and complete recovery of the movement is expected. Rarely, the nerve can be cut. This is extremely rare, but if it does occur, recovery could take 6 or more months and may not be complete, leaving that brow weaker than the other.
In the vast majority of cases, however, the brow movement returns completely, so be patient.

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 25 reviews

Keep the faith

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Nerve bruising and/or stretching may occur during a brow lift operation. This may temporarily injure the nerve that causes your brow to move. In the overwhelming majority of patients the nerve function returns to normal, but the recovery may take six months. Have patience, trust in your surgeon. If it is disfiguring at this point you can consider temporarily paralyzing the other side with Botox for symmetry until the injured side returns to function. Good luck!

Wait up to 6 months or so

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I suggest you follow your surgeon’s advice and give it a bit more time - maybe up to 6 months or so, during which time movement will gradually return. The muscle or nerve responsible for movement of your one brow may have been affected during surgery, however it usually corrects itself as you recover.

Browlift concerns

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What you have described can be expected after a brow lift.  I recommend keeping in close contact with your surgeon or his/her clinical team to address your concerns.

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

You're Still in the PostOperative Period Following a Browlift, Healing May Take Up To Several Months

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Brow lift surgery can have a dramatic impact on facial aesthetics, but there is also the potential to have complications with this type of surgery. There are several different types of brow lift that can be used to address brow descent. One thing that they all have in common is the potential to damage the frontal branch of the facial nerve.
This nerve is responsible for elevating the eyebrow. During surgery, the nerve can be divided or damaged, and when this happens, eyebrow elevation is no longer possible. This may be a permanent problem. More commonly the nerve is stretched. When this occurs, the paralysis is transient and function usually returns with time.
You’re still early in the post-operative course, and there’s a good chance that this will improve with time. Be patient, your surgeon’s assessment is probably correct.

Frozen eyebrow after browlift

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Occasionally patients will experience temporary eyebrow asymmetry after an endoscopic(non-invasive) or coronal (open) browlift.  This brow asymmetry is due to lack of elevation of the affected eyebrow, with that brow appearing lower than the opposite unaffected side.  Occasionally the nerve that elevates the eyebrow can be stretched or bruised during surgery, resulting in weakness and lack of elevation  that usually returns within 6 months.  Uncommonly it can be cut resulting in permanent brow asymmetry.
In patients that have this temporary asymmetry, Botox can be placed to weaken the normal eyebrow to make them appear more even until full function returns.  Try to be patient, and address your concerns with your surgeon. 

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.