Is it possible my body is rejecting the endotine fasteners used during my Browlift?

Question

Had brow lift with endotine exactly 3 months ago. I have severe pain as if I am being shocked when I touch the nobs where they were placed, pain when I sneeze, couch lightly brush hair, it's as if I have been shocked , the pain even radiates to down face and to back of scalp when touched. This can't be normal, can it? Is it possible that my body is rejecting them?

Marc DuPéré, MD · Answer

Thank you.The endotine anchors do dissolve by inflammation and it is possible to have some tenderness over where they are.The scalp also has mutiple sensory nerves that can get affected in a forehead lift.Usually, those issues are temporary. But should this be significant enough, and it seems to be as per your description, the anchors can be removed easily with small incisions.Let us know if this information was useful.

Best regards,

Dr. Marc DuPéré, Toronto aesthetic plastic surgeon and facialist

Best regards,

Dr. Marc DuPéré, Toronto aesthetic plastic surgeon and facialist

Evan Ransom, MD, FACS · Answer

The endotine device will dissolve, but this can take a while. In cases where there are wound complications or significant discomfort, it can be removed with a small incision. For patients with a relatively thin scalp, this may be more common.

John J. Martin, Jr., MD · Answer

The endotine will often cause some discomfort when you touch it.  This is especially true in certain cases where the endotine must be very close to or touching the supraorbital nerve which runs from the eyebrow up over the top of the head.  It will dissolve at which time the pain will subside.  If it's really bad it can be removed with an incision over the implant.

Vartan Mardirossian, MD · Answer

The area of distribution of the pain corresponds to the supraorbital nerve territory which is in the area where the endotynes are placed. I am surprised that no one mentioned it with the correct nomenclature. Anyways, the pain should subside as the endotynes absorb...

Stephen Prendiville, MD · Answer

An endotine is an absorbable implant made out of polylactic acid placed in a very deep tissue plane to allow for fixation of the brow in a browlift procedure.  It is normal to have pain if the area around the device placement is touched because of the sharp edges of the implant prongs.  I instruct my patients to avoid combing hair directly over the implants of touching the "bump" associated with the implant. This problem should become much less of an issue in the next 3-4 weeks.

Thomas Romo, III, MD · Answer

The endotine device has sharp points on it inorder to fix and hold the brow lifted tissue in proper position for healing. One of the known downsides in using this device is that the points can cause localized pain when touched. This usually goes away as the device is absorbed by the body. If your pain continues, you need to see our surgeon.

Jeffrey M. Joseph, MD · Answer

There are many branches of sensory nerves that run through this area of the forhead. If the endotine is close to or irritating one of those branches it can cause the symptoms you describe. It should resolve with time, but during this time, you may have continued pain.

Darryl J. Blinski, MD · Answer

Doubt a rejection of the inert material in the endotine. I believe from your excellent description the endotine is inconstant with a frontal sensory nerve causing the described pain. Only removal would allow a possible correction...