Drooping upper eyelid after mid - facelift

Drooping of your forehead after facelift can be the result of temporary or permanent damage to the one of the branches of the facial nerve. Typically this is temporary due to swelling and stretching the nerve during dissection and will resolve with time. Continue to follow-up with your plastic surgeon for monitoring. 

You
shouldn’t really have that problem after a facelift.However, it could be a facial nerve injury that
has occurred. If the nerve is just stretched it may be improved, but if it is severed,
it may be irreversible.

Hello.  Thank you for your question.  One of the risks of a mid-face lift is injury to the temporal branch of the facial nerve, which stimulates movement of the forehead and brow.  Injury to this nerve can result in weakness or paralysis of the movement of the brow on the injured side, which can give the appearance of drooping of the upper lid.  This is typically the result of stretch injury to the nerve, or swelling around the nerve, and will typically resolve completely over time.  However, this may take several weeks to months.  The incidence of permanent nerve injury is very low.  Botox can be used on the opposite side to help alleviate asymmetry until the nerve function returns.  I would encourage you to discuss this with your surgeon and allow him/her to evaluate you and determine the best management.  Best of luck to you in your recovery.

This early after surgery, I would recommend massage of your lower lid upward to help counteract any scarring that is forcing your lower lid down.  Forehead paresis may be due to nerve injury but at this stage one would recommend waiting to see if the nerve recovers function.  Discuss this with your surgeon. 

Based on your description I suspect that you've had a stretch injury to the part of your facial nerve that innervates the brow. This likely happened during your midface lift. In most cases, this is temporary and should return over time. It is also possible you the eyelid droop is something referred to as eyelid ptosis but there is no mechanism by which your surgery could have resulted in that type of issue. In most cases, the brow weakness will resolve in weeks to months. Keep in close contact with your surgeon. Botox to the opposite side of the forehead is also a good option in the meantime to camouflage the asymmetry in your brows. Please discuss with your surgeon. Best.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Thank you for your question. It is important to remember that you are still early in the post operative healing phase. Therefore what you see currently will change significantly over the coming weeks. With any facial surgery swelling can result in asymmetry between the left and right sides of the face. Facelift procedures can also produce swelling and bruising of the nerves of the face that can result in temporary weakness. Although rarely the nerve damage can be permanent it is too early to make any judgement and the best person to talk to is your plastic surgeon. I hope that helps.RegardsDr Guy Watts

marthabuddy, your surgeon most likely somehow injured the frontal branch of the facial nerve on that side. You need to let them evaluate this. the vast majority of times this will come back but can take several months. See your surgeon. Good luck!

Dear Martha, Some nerve dysfunction is quite common after extensive facial surgery. Considering your two concerns, I can assure you that it is highly unlikely that the muscle that lifts your eyelid is affected. That problem is most likely caused by some dropping of your left  eyebrow, due to some dysfunction of a nerve. A recent survey on a large number of face lift patients showed that this type of temporary nerve dysfunction recovers spontaneously in 95% of the cases within 6 months, without any treatment. Permanent lesions to nerves are very uncommon (less than 0,1%) and even if that would be the case, it can often be repaired. I completely understand your concern, but I would advise you to be patient; it will almost certainly recover within the next months. If it is the asymmetry that bothers you most, you could also get a botox treatment on the right side of your forehead, this will result in a more balanced appearance. I also advise all patients who underwent nerve damage (of any kind) to take vitamin B supplements; it won't harm you and it stimulates nerve regeneration. I hope I managed to reassure you somehow and I wish you a good recovery!dr Hendrickx

It's not atypical to have some nerve weakness after a facelift. The type you are describing is more common when there is also surgery of the brow. The nerves can be stretched during surgery or stretched by the swelling after surgery. There is typically full resolution over a period of weeks to sometimes months. Be sure to make your surgeon aware of the issue as there may be some further intervention they suggest. Hope that helps!CDK

I am sorry you are having some problems after surgery. The key thing that you need to answer is if immediately after surgery were you able to move the left brow or if the problem happened days to weeks after.If the problem was immediately after surgery you could have damage to the brow segment of the facial nerve or the swelling shunt it down. In the majority of the cases the facial nerve will start moving several days to weeks if it is due to stretching or swelling. In very few cases, if the problem was due to damage to the facial nerve, then it might take longer to recover and depending on the amount of damage then is how much you can recoverIf the problem started days or weeks after the facelift, then the problem can be similar to Bell's Palsy. It should recover days to weeks after. and is a good prognosis for the nerve if it was this last problem.Hope this helps,Dr. Gus Diaz