Temples Have "Pins and Needles" Tingling 5.5 Mo. After Face and Brow Lift. What's Happened?

Question

Left temple down to side of face still tingles when rubbed. Right temple tingles less and that eyebrow recovered,but left frontalis muscle still paralyzed and 1" lower w/o Botox. Is this common this late? A sign that paralyzed left eyebrow could recover? If braided suture DID fail on paralyzed side (as doc thinks)would this cut the frontalis or did it just get injured in surgery? Does it need removal? How often does this happen? I am so worried it will never recover. My eyes have no expression.

Sam Naficy, MD, FACS · Answer

The tingling and numbness is quite common and should improve with time (up to a year).  The muscle weakness is less common but it too typically improves over time.

Ronald Schuster, MD · Answer

It sounds like you have a couple of things going on. The pins and needles are from your sensory nerves growing back. These are fine wispy little nerves that are always cut during surgery and generally grow back fine over time. Feeling generally is noticeable better by 3months after surgery but can certainly take a year or so. You should massage the areas nearby to encourage the nerves to grow towards the right places and break up scar tissue that may be in their way. The paralysis is different. This is from injury to the nerves that go to the muscles. They could have been stretched, bruised, cut or caught in a stitch. By 5months  after surgery I would have thought that you would have seen some recovery. If not that's not a good sign. Try to exercise that portion of your forehead to encourage the nerves to grow. If nothing improves you may need to do Botox to the other side to get them to look more even. I would avoid Botox to anywhere near the affected area though for now nice you won't be able to tell if the muscle is getting stronger. Hope this helps. Good luck.

Lawrence Kass, MD · Answer

The pins and needles sensation is a sign that your sensory nerve endings are recovering. The droopy brow is related to possible damage to a MOTOR nerve (frontal branch of facial nerve). In most cases this will recover on its own in 12-18 months. There really is nothing to do at this point, other than Botox to the opposite side to improve cosmesis while the nerve heals. Good luck!

Temples Have "Pins and Needles" Tingling 5.5 Mo. After Face and Brow Lift. What's Happened?

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