Sudden Eyebrow Paralysis After Face Lift and an Upper Blepharoplasty - 1 Month Post-op.

Maria

It is certainly possible that this did suddenly develop one month after your facelift and eyelid surgery.  This would be very unusual.  If this is actually correct, then I would be concerned that this might be a form of Bell's palsy.  There are some other potential causes.  However, they are all pretty unusual.  Another possibility is that you had an injury to the right temporal branch of the facial nerve at the time of surgery and it was not noticed until now.  This might seem shocking but a lot of thing are going one as you heal from this type of surgery.  Before you dismiss this possibility please know that this is most likely situation.  What do I recommend at this point, you and your surgeon should closely follow this.  I know that this will also sound a bit strange but unless your surgeon examined you very carefully, you may have had this weakness before surgery.  However, if you were not examined for this, of course your surgeon is still responsible for the weakness (because it was not documented).  I would say the most likely possibility is motor nerve injury at the time of surgery.  Will this recover?  Many of these injuries do recover but it can take months and there may be residual weakness.  On the other hand, if your facial weakness seems to be getting worse and spreads to the lower half of the face, this will warrant a more complete neurological work up. 

Loss of motion in the forehead 1 month after a Facelift is very unusual.  If the entire hemiface was involved it could be attributable to a viral etiology as in Bell's palsy.  Although the frontal branch of the facial nerve is theoretically at risk during a Facelift, sudden loss of motion in the forehead 1 month after surgery  is hard to explain.  However, your Surgeon is correct that motion is likely to return.  If you were my patient, I would probably place you on steroids and antivirals to cover all of the bases.

Given the timing and description of your symptoms, I would favor that you sit tight.  Nerve function will come back but it will just take some time.  In the interim, make sure you keep your plastic surgeon in the loop.  Good luck things will get better.