My surgeon says to wait, and the movement will return. What could have happened?
One Brow Not Moving 1 Month After Brow Lift
Doctor Answers 32
Frontal branch injury typically temporary following Brow Lift
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.
Correction of weakened brow movement after browlift varies on surgery performed
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
- Transblepharoplasty brow lift (through the eyelid)
- Direct brow lift (excising skin above the eyebrow)
- Pretrichal Brow/Forehead Lift (in front of the hairline)
- Endobrow lift (Forhead lift using endoscopic techniques )
- Coronal brow lift (incision across the scalp from ear to ear)
- 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.
It takes time, but almost always the nerves start working just fine.
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
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Brow Not Moving After Browlift
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.
This should get better
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.
Keep the faith
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
You're Still in the PostOperative Period Following a Browlift, Healing May Take Up To Several Months
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
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.