Disfigured by Brow Lift in Costa Rica
I went to...
17 Dec 2013
9 months post
Disfigured by Brow Lift in Costa Rica
I went to Costa Rica for a facelift and upper/lower bleph in March 2013. During my only in-person consultation 12 hours before surgery, the doctor told me he needed to “anchor” my brows with a brow lift procedure. He showed me a post op photo of a woman with pencil-thin scars across the tops of her eyebrows and I told him that wouldn’t work for me because my skin doesn’t heal well. He then said he could make the cut on my head behind my hairline. Since he had just shown me a pencil-thin scar, I thought he was talking about a very thin cut on the top of my head.
From my research about blepharoplasty, I knew that brow lifts are sometimes done at the same time. I recalled seeing warnings that brow lifts are not appropriate for women with high hairlines, so I never read further. I told the doctor I had seen these warnings. I pointed out my naturally high hairline and said that I couldn’t risk it being raised. He said that any change would be insignificant. He told me he wouldn’t do the eye surgery without the brow procedure, so I felt I had to trust his experience.
I lost a great amount of hair during the surgery, including along my hairline. The doctor told me it was "shock loss" and that my hair would begin to re-grow in 3-6 months. At about 3 weeks post op I started to recognize my former hairline – but it was much higher. I asked him to tell me exactly what he did in surgery, and only then (a month after surgery) did I learn that he removed half an inch of my scalp during the brow procedure. This explained my new huge forehead and massively receded hairline.
The disfigurement was severely traumatizing and my life came to a halt. Four months after surgery, after months of research and consultations, I had hair transplant surgery with Dr. Jerry Wong of Hasson & Wong in Vancouver, B.C. The procedure took 8.5 hours, during which 2,081 hair follicles were removed from the back of my scalp, dissected, and “planted” in new follicles created to restore my hairline. Dr. Wong has performed more than 8,000 hair transplants and is a master in the field. It has now been 5 months since my hair surgery and the new hair is starting to grow in nicely. It will take a year to see the full results.
Unfortunately, that’s not where the story ends. It’s now been 9 months since my surgery in Costa Rica, and I am still suffering from nerve damage from the brow lift. The only type of brow lift that the doctor performs is the most extreme – the coronal brow lift, with a cut from one ear, across the entire top of the head to the other ear, removing half an inch of scalp and pulling the forehead up to close the cut. Even after 9 months, when most people have healed, I have intense neuropathy: numbing, clamping, hot and cold sensations, and pins and needles. No-one can tell me if I will recover. The right side of my head is healing nicely and it is not numb anymore, but the left side is improving very slowly. It’s distracting and uncomfortable all of the time, and often painful.
After seeing photos of my receded hairline when I returned to the U.S., perhaps the doctor finally realized he made a mistake. In any case, he offered to pay 100% of the cost for a hair transplant if I returned and had it done in Costa Rica. When I checked out the "transplanter's" website, I found that she didn’t even list hair transplants among her 20 or so cosmetic procedures and specialties. My doctor wanted me to risk this highly specialized procedure - and my only chance to correct the disfigurement that he caused - with a surgeon who doesn’t even specialize in hair transplants!
I’ve communicated with the doctor and his U.S. coordinator. The doctor insisted that I knew that the procedure would raise my hairline half an inch and that I had agreed to it. I pointed out that I never signed anything outlining the details and risks, or stating that I agreed to raise my hairline, nor did he provide any written information before surgery with the details and risks. His website also did not include a warning about the hairline. I reminded him that I expressed concern that the brow procedure would raise my hairline. I would never have given him permission to remove half an inch of my scalp, recede my hairline, or change my brow position. When I wrote his U.S. Coordinator to ask for a refund, she wrote me an irate letter telling me I was a big problem for her and that she was going to block my email.
Because of what happened to me, they now have a warning on their website (Eternallyvain.com) and require patients to sign a waiver. I urged them to put this up to make sure that other women do not suffer what I went through.
Please be careful in Costa Rica. If anything goes wrong, there is no recourse. The doctors know that you are flying home and can’t return easily if there are problems. Three out of five women I've stayed in touch with from the recovery center in Costa Rica had serious problems – one of them with this same doctor.
The internet is full of warnings by cosmetic surgeons that the Coronal Brow Lift is not appropriate for women with high hair lines. Even when I pointed out my high hairline, the doctor assured me it wouldn’t be affected. I will never understand how a cosmetic surgeon with over two decades of experience could have thought this procedure was appropriate for me. I have suffered unimaginably as a result of his gross negligence. He has not taken responsibility for his mistake, and has not dealt with me honorably.
Also, if anyone has anything to share about nerve regeneration, I’m very interested in your experience.
(Regarding the cost: $6,000 was the full amount I paid for surgery. They refunded $700 because of my dissatisfaction with the Brow Lift, but refused to refund the rest of my money.)
Negative Review of Dr. Alejandro Lev, Costa Rica
21 Feb 2014
11 months post
It has now been over 11 months since my surgeries with Dr. Lev. I still have debilitating pain from the crown of my head down the entire left side along the brow lift cut line. The neuropathy pain has decreased but not the extreme tightness, clamping, and heat that I experience. Sometimes it’s so bad that I have to lie down to relieve the pressure. It feels so tight that I’ve wondered if Dr. Lev removed too much of my scalp. The acupuncturist that I’m seeing believes that the scar tissue along the cut line is a part of the problem. The scariest part continues to be not knowing if I will ever fully recover.
I have continued to research brow lifts and especially the Coronal brow lift that Dr. Lev performs. There are so many surgeons speaking out about this procedure due to the numbers of people left with nerve damage and extreme hair disfigurement. Two surgeons who posted right here on Real Self had this to say:
“A Coronal brow lift is, in my opinion, a historical approach with very little relevance in contemporary facial rejuvenative procedures. Patients with an acceptable hairline can be addressed endoscopically, and patients with a high hairline can be addressed with a trichophytic approach. A coronal approach raises a hairline and requires a large incision. The only time I currently use a coronal approach is for trauma cases.”
“The coronal lift is a surgery performed by cutting from one ear to the other, all the way through the scalp. This makes a huge incision that damages the scalp and can cause permanent hair and sensation loss. Variations include moving the incision to along the hair line. Surgeons who still perform this debilitating surgery are insensitive to the damage they cause in their patients.There is almost no reason to perform the coronal brow lift. It is a surgery that appropriately frightens any reasonable person. The small incision brow lift is highly effective, with rapid recovery, and typically no loss of hair or sensation. Those who cling to the coronal brow lift use a variety of arguments to justify their choice. Don't be taken in by their charms or their arguments.”
I’ve uploaded photos of my hairline before and my hairline after, showing the severely receded hairline that Dr. Lev left me with, plus what I looked like right after the hair transplant surgery. You can see that I had a naturally high hairline that was receded significantly by the Coronal Brow lift. My hair tranplant in July 2013 was successful but some of it is just two inches long. It will take another 5 months for it to grow in and blend more, and then I'll be able to assess the final result.
Dr. Lev left me with clearly visible scars on the bottom of both earlobes from a shoddy stitching job. My right earlobe is now unnatural shaped (squared instead of rounded) and much smaller than the left one.
I have a scar on my left upper eye lid that is quite noticeable. That eyelid had too much skin removed and it makes my eyes appear assymetrical. He also removed too much tissue below my right eye which has left a long horizontal dent below my eye.
He completely removed my sideburns which were a strong feature on my face. My sideburns came down to the bottom of my ears and now they are gone. Again, he didn’t warn me or ask me. I am still shocked as it is tell tale sign of a facelift and I don’t know if I’ll ever be able to wear my hair back or up.
Everyone here who has had hard experiences like I have knows the challenging psychological effects: depression, anxiety, etc. that one has to deal with daily. Thank you to those who sent me encouragement and shared your stories with me. I really hope my story will motivate other women to ask for the honest details of their procedures. Things like “where will the cuts be made”, “how much skin will be removed,” “how will you protect my sideburns,” “exactly how will this distort or change my hairline,” “what is the risk of permanent nerve damage”, “how much are you proposing to raise my brows”....every detail is an important one and your surgeon should inform you and get consent for every procedure. You should not learn about the details of your surgeries after you wake up from the procedures.
16-month update on brow lift disaster with Dr. Lev in Costa Rica
Very sad to report that next week it will be 16 months since my surgery with Dr. Lev and the nerve damage/pain still prevents me from working or having a normal life. I still have intense clamping, pressure and sometimes burning pain along the coronal cut line on the top and left side. The entire left side of my head was and still is numb, from below my ear to the top of my head. I have been having some success with Cold Laser Therapy and am having some longer periods where my head feels looser. It is clear that I suffered nerve damage on the left side.
There is a large depression on the top left side of my head along the coronal cut. The depression is the diameter of a golf ball and it is sunken down about a quarter of an inch. There is also a very pronounced ridge along the rest of the coronal cut, especially on the top. The hair in this area and along the rest of the scar lines is severely damaged/retarded. It is not anything like normal hair and will not lay correctly because the dents and ridges make the hair turn. The hair on the rest of my scalp has also suffered greatly – it is now thin and damaged, and I’ve lost a great deal of it. It’s an extra layer of trauma and sorrow that I’ve suffered as a result of the Coronal brow lift.
The tight “chin strap” and choking feeling lasted about a year. Now, at 16 months, if I bend my head and look down, I still get a choking sensation; If I try to look up at the sky, there is not enough skin under my chin to fully extend my neck. When I smile or laugh, the Coronal cut line on the left feels like it wants to split open, and my skin is extremely/unnaturally tight on my temples and forehead. My jaw line is also unnaturally tight and unlike anything I've ever looked like. It is masculine looking - not flattering. The softness and original shape in my lower face is gone.
My left eye:
The outer corner was pinched when it was sewn up and it doesn’t lay or close right and is a constant irritation. The eye slants upward in a strange position when I smile. I now have a large eye-lid showing on the left eye. I was very clear with Dr. Lev that because my upper eyelids have been full my entire life, I've never had exposed eyelids and didn't want any now. There is a vertical dent in the upper lid where the doctor made an extra vertical cut. And most of the eyelashes on my lower eyelid are gone, giving the eye a naked appearance.
My right eye has a large horizontal depression running the entire length of the eye underneath the lower eyelid.
The scars on my earlobes have not healed smoothly. The left ear lobe has a nice shape to it but the scars are visible - big frankenstein like stitches with uneven skin. The right ear lobe is much smaller and has a square shape instead of a rounded one. It doesn’t match the other one at all and does not look normal. It too has large visible scars from the bad stitching.
When I tuck my chin down towards my chest, there is now a large bulge on the right side of my neck, below my jawbone and above my neck. I have no idea what to expect from this in the future.
Didi insists that Dr. Lev is a man who discloses every detail and would never do anything without the patients full understanding. My neighbor at the recovery center who had the exact procedures with Dr. Lev the day after me told me recently that she also didn't come for a brow lift but that she agreed to it during her consultation when the doctor told her she needed one. She said she was also shocked to learn after surgery that she was cut ear to ear. We are two examples of patients that did not have anything near proper discloser about the Coronal Brow Lift, despite our asking for them. To each of us, he made it sound like it was a small cut up behind the hairline. Had we heard the reality, we would never had agreed to this procedure.
Dr. Lev has never apologized nor did he return my money. I am happy for everyone who has had great results with Dr. Lev, but I am not one of them. With all of the amazing testimonials about his precision and stitch work, it makes me wonder if an intern was working on me that fateful day. Also I think it's clear what kind of care you can expect from Didi if you have any problems. Right here on my review she attacked my character, threatened to post my before and after photos, and exposed confidential client information that she had no legal right to do. She claimed she had to repeat things over and over to me during 6 months of email correspondence when we actually met for the first time only 6 weeks before my surgery. Just be aware of who you're dealing with.
Thank you for the notes I continue to receive from lovely people I've met here. I appreciate your support, care, and continued prayers for this painful healing journey.
19-month Update on Brow Lift with Dr. Lev
It's now almost 19 months since my fateful surgery with Dr. Lev and little has changed since my last update 3 months ago. I've had a lot of time to reflect on my experience. The bottom line for me is this: I didn't go to Dr. Lev for a brow lift, and because he added it in at 5:30 at night, 13 hours before my scheduled surgery, I was COMPLETELY dependent upon him and upon their website for information about the procedure. (This is a huge difference between Costa Rica and the U.S., where you would never have your first consultation the evening before your surgery, and there's time to research whatever the doctor is proposing.) Their website said nothing about an ear to ear cut, half inch of scalp removal and hairline recession, or the high likelihood of permanent nerve damage and hair loss. If Dr. Lev had had the courtesy to share any of these details with me, I would never have agreed to the procedure. I even showed him my high hairline and told him it couldn’t be raised and still he did not disclose the half an inch scalp removal. He never once said that I was a “borderline case” for a Coronal Brow lift or warned me in any way, as Didi continues to claim (which is hearsay because she wasn't even in Costa Rica at the time).
In our country, what Dr. Lev did is considered medical malpractice and I have no doubt that I would win my case. I have many photos showing the gross disfigurement of my hairline and am preparing to publish some of them here. I will also start posting photos of the other issues I've mentioned, including my skeletonized eyes.
My hair continues to deteriorate - nothing more to say about that. It's heart-breaking to lose my hair at age 55.
I'm now applying for Social Security disability. My medical expenses and lost wages exceed $85,000, and it's impossible to put a figure on the pain and suffering I've experienced. My lost wages and medical expenses will continue to climb as I have no confidence that I will get through this soon. Didi says I asked the doctor to refund my money as a way to get a free trip to Costa Rica and free surgery. Wow - what a concept. This trip has pretty much cost me my life.
The last thing I'll add is about this review. Again, in Didi's distorted view, I'm out to ruin the reputation of a good doctor. In my world, I'm out to save women from a procedure that could ruin their life, and offer a warning about a Doctor who doesn't think he needs to disclose the risks. Because of what happened with me, Dr. Lev now has people sign a disclosure so that they understand that the Coronal Brow lift will recede the hairline about half an inch. But it doesn't say anything about the ear-to-ear (head-phone pattern) cut, the high potential for permanent nerve damage or the high risk of permanent hair loss and thinning, as all other reputable surgeons disclose. In fact in their entire website, you will not find any information about the length of this cut! The disclosure also gives a 1% chance of permanent nerve damage. Do the research - the risk of permanent nerve damage is quite high with a Coronal Brow lift. I am glad that women have the chance to learn here about this dangerous procedure, and will hopefully research more so that they are fully informed - something they will not get from Dr. Lev.
Photo of disfigured ear lobe
I had normal, beautiful, round earlobe before my surgery with Dr. Lev and this is my earlobe now - square and completely unnatural looking. When I asked him about the shape after surgery he told me that the healing process is amazing and that it would be fine. It was square after surgery and it's still square. I didn't know it was possible to mess up on an earlobe.
Before and after photos of my eyes
Here are two before and two after photos of my eyes. I told Dr. Lev that I had always had fullness between my brow and my eyes all of my life and that my upper eyelids had never been visible, nor did I come to him to create upper eyelids. I came to get a short slice of skin removed that was falling onto my eyelashes and bothering me, and I wanted to keep the fullness between my eyes and brow. I told him no-one would recognize me if he gave me visible upper eyelids. Guess what he did? He gave me large eyelids, crooked eyes, a lower eyelid that pulls down, and a large horizontal dent below my right eye. He didn't listen to what I wanted, and created many new problems.
before and after shots of forehead/hair
You can imagine, seeing these photos, why it's taken me so long to post them. It is traumatizing to look at my post surgery photos of the huge forehead and the gross disfigurement that Dr. Lev created for me by cutting half an inch of scalp out from the top of my head and pulling my forehead up to close the suture. He destroyed the symmetry of my hairline and my face. Here are a few photos that hopefully convey it clearly.
4+ year update on brow lift disaster with Dr. Lev in Costa Rica
I haven't posted any updates because everything just gets worse and it's depressing to come here. Tuesday I go in for surgery to cut two permanent sutures (behind my ear and in my neck), because I am as choked today as I was the day after surgery. Dr. Lev sent his "surgery report" a couple of years ago that said he used dissolvable sutures in this placement but you can feel the knots through the skin behind my ears and my surgeon can see the color of the suture thread running under the skin. We're praying this will release pressure on the greater auricular nerve, which is clearly damaged because I have the classic symptoms - I'm completely numb in my lower ear, side of face and around the ear. I'm praying that releasing the sutures will relieve the choking sensation and help to heal the nerve.
I have a fraction of the hair that I had 4 years ago, and going downhill. The blood supply to my scalp is so compromised from the deep coronal cut (ear-to-ear), that my straw-like, brittle, thin hair doesn't even feel like hair. As many people have already discovered, hair transplants are not an option if you've had a coronal brow lift. I'm finally giving up after watching it fail year after year and going in for supplemental hair.
The pressure and pain on the coronal cut line (top and left side of head) continues to be unbearable. I feel like I'm walking around with 5 bricks on top of my head, like my scalp is 2 sizes small for my head. I will have more imaging to see if they can detect anymore sutures in my scalp. The last MRI report suggested that the pockets of edema and prominent tissue changes may be suture granulomas - where the body sees the sutures as foreign bodies and tries to attack and expel them. The scars on the brow lift cut are bizarre - huge depressions and lumps across my head. Combined with the balding along the scar and my part-line where those tight sutures were placed, it's not a pretty picture.
I've spent $18,000 trying to fix my left eye that was mangled. I'll talk about that in my next update.
I did hear from Dr. Lev's attorney a couple of years ago offering me my money back if I would remove this review. I declined the offer and asked for something like $80K, given my medical bills and lost wages (which now total over $200K). I'd rather he keep his 5K for the satisfaction I get from knowing that this review is helping to educate people about the coronal brow lift - an antiquated and dangerous procedure. I will post more photos soon because I no longer care who sees what.
The bottom line for me is what I've said from the beginning: Had Dr. Lev told me he would be cutting out half an inch of my scalp, or told me that my hairline would be receded by half an inch, or told me that the chance of permanent nerve damage was high due to the extent and depth of the cut, or that hair loss and thinning is a common side effect, I would have said "no thank you." He completely misled me about the nature of a last minute add-on that I had no time to research on my own. As my surgeon, he was obligated to disclose this information. Instead, all I got was, "A small cut buried in your thick hair." And now even my thick hair is gone.
MRI findings: "Prominent abnormal STIR hyper intensity signal is seen in the facial soft tissue bilaterally. It extends from the temporal fossa to the maxilla and mandible, mostly on the left side and posteriorly to the ear, with temporal muscle edema adjacent to the skull. Ovoid structures may represent suture granulomas."
June 22, 2017 Update
There are so many issues with Coronal Brow Lifts that are presented here on realself, and so many doctors warning people that this procedure is outdated and comes with serious issues. Two years ago a woman posted a couple of heartbreaking photos of a large bald band across her head (https://www.realself.com/question/ct-start-worry-hair-growth-large-coronal-brow-lift-scar) and a wise doctor from Spain posted this in response:
"Coronal forehead/brow lift is obselete nowadays and I am afraid you have been a victim of an outdated procedure. The consequences you have are not a result of a bad execution of the techqnique, they are features of the technique itself. The coronal forehead lift without internal anchors is based on the principle of skin resection and pull backwards, being the closure the support element for the uplifted forehead. The downsides are:
-baldness around the incision, sometimes irreversible
-numbess of the scalp, irreversible
-widening of the scar with great visibility"
Direct brow lifts are also called "antiquated" and "outdated" here on real self, and many doctors will not perform them or will not perform them on women because of the scarring. If you are consulting with a surgeon who tells you that these are the only two types of brow lifts offered, take it as a sign to move on. They need to update their procedures. Same with eyelid surgery: old style was to remove lots of fat, which creates hollow eyes. I'm having surgery this summer with a renowned ocular plastic surgeon in LA who specializes in fixing all of the issues from doctors who are not up to date in their training or should not be operating on eyes at all. I have severe hollowness and a pinched canthus that collapsed the eyelid rim and gave me a small, deformed snake eye. I've already spent over $15,000 trying to correct these issues but I'm confident that the surgeon will do a great job and I anticipate posting another great review for him.
I had surgery three weeks ago to remove the permanent sutures that were anchored behind my left ear on the mastoid and around my jaw bone. My surgeon could feel two knots and she could see the running line, and since it was in the area of the greater auricular nerve, felt it best to remove it. She removed 3.5 inches of running suture that ran up in front of my ear and down below the jaw in the neck. My result three weeks out is that I have less of a choking sensation and I can open my jaw without the stinging pain I was experiencing. My neck is still tight and uncomfortable and I still have a lot of nerve pain from the coronal brow lift but any reduction in pain is welcome. My surgeon says to give this 6-12 months for the nerves to heal. She said that the permanent suture that Dr. Lev used ran in a corset pattern (back and forth). I asked her if this was a common placement in her opinion and she said it's called a "plication" suture and that it is a more superficial way to try to hold up tissues that some surgeons do routinely. She said she tightens the tissues at a deeper level and does not do plications or use permanent sutures.
I'm deeply grateful to Dr. Henderson and will be thanking her with a great review here. She was so skilled and showed so much compassion for the suffering that I have endured. I brought her my before and after photos to show her some of the issues and she said that in my after photos at 5 and 7 weeks, I am completely unrecognizable as the same person (in the negative sense of the word). Yes - disfigured.
"Disabled" ruling by very tough Social Security Judge.
Almost 4.5 years post surgery, I just won my Social Security disability hearing. I was assigned to one of the toughest judges in Seattle - to date in 2017 she has only approved 19% of her cases. All of my doctors were in complete agreement in their reports: my physical therapist, family doctor, surgeon and neurologist: chronic debilitating pain from nerve damage from the coronal brow lift. The MRI scans back it all up. Devastating.
The emotional pain from having a severely receded hairline, baldness and significantly damaged/distorted hair is as great as the physical pain from the nerve damage.
I found this quote from a doctor here on RS in response to a question about the impact of the brow lift: "Your surgeons familiarity with the anatomy will also impact which complications can occur. The list of any surgical complication will be included in your pre-operative discussion with your surgeon."
Please be aware that in some countries, pre-operative discussions and disclosures are optional. In my case, I asked twice about the impact it would have on my high hairline and was assured that any change would be insignificant. Wow. And as for the ear to ear cut, he literally called it a "small cut buried in my thick hair." And as for the half an inch of scalp removal? I guess that little detail was so Insignificant (or perhaps too gruesome?) that he needed to leave it out. His coordinator in LA sent 3 of us down from the U.S. and Canada to have our surgeries with him 3 days in a row and we all recovered at the same place. He gave two of us coronal brow lifts and did not disclose the details to either of us...we were both shocked to find ourselves cut ear to ear after surgery. He characterized it very similarly to both of us: "small cut".