Is Steroid Medication Given for Swelling and Pain from a Coronal Brow Lift?

Question

i need to know the best medication possible to be used for this procedure.to cut swelling and pain.

Larry S. Nichter, MD, MS, FACS · Answer

Although many surgeons give steroids for swelling there is little scientific evidence that the total swelling is decreased after surgery using this approach. That being said there is good evidence that pain and nausea control is better when short duration steroids are given - that is, less narcotic pain medicines are generally required. There are certainly risks with giving steroids for more than 3-4 days ( the more days - the more risk), including increased risk of infection, emotional lability, hypertension, etc). My own practice is either no steroids if an office procedure, or if done in a surgical center a single IV dose at the time of surgery is given to decrease immediate post operative pain and nausea.

Andrew Pichler, MD · Answer

Swelling is usually not a major issue. Pain is fairly common because of transaction of the frontalis sensory nerve (which in most cases regenerates to almost 100%). Short course of oral cortisone and local injection with anesthetic/cortisone combination will lessen this problem.

Michael Sundine, MD, FACS · Answer

I have typically not used steroids for swelling associated with a coronal brow lift. The swelling usually is at its maximum two days after the surgery and resolves very rapidly thereafter. Many patients who receive oral steroids develop some significant mood depression about two weeks later and for this reason I have avoided the use of steroids. At the end of the procedure I inject a long acting pain medication that gives early postoperative pain relief. Following this, oral pain medications seem to be adequate for postoperative pain relief.

Richard W. Fleming, MD (retired) · Answer

Pain after any type of brow lift is limited. I do a nerve block with Marcaine after surgery to minimize pain immediately after surgery. I also give patients Medrol, which is a 6 day regimen of steroids which will decrease swelling, one of the major causes of post-op pain.

Sheldon S. Kabaker, MD FACS (retired) · Answer

For most of our facial plastic surgery procedures , including brow lifts, forehead reductions and hair transplants, we give short and long acting corticosteroids usually by intramuscular injection while the patient is asleep. I strongly believe that this lessens the amount of post operative swelling. I am not sure it has any affect on pain. Injections of a long acting anesthetic into the nerves at the eyebrows and temples are routinely given to lessen the postoperative pain that we otherwise see in post operative browlifts or forehead reductions. It is rare that coronal browlifts are done these days, but the approach to this procedure is what is the surgeon's preference . Pain and swelling differ little with all the approaches.

Ronald V. DeMars, MD (Retired) · Answer

Good question. In my practice we routinely give patients a 3-4 day course of a steroid called prednisone which does seem to help. We also inject an anesthetic called marcaine into the temporalis muscle area at the end of the procedure as well as a little above the nose and eyebrows so patients wake up with no pain. But even without these adjunctive treatments, most patients are getting off their pain medications in a very few days after browlift.

Is Steroid Medication Given for Swelling and Pain from a Coronal Brow Lift?

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