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Disfigured by Brow Lift in Costa Rica I went to...

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

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.”
And:
“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.

Other issues:
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.

Provider Review

Plastic Surgeon
Plaza Mayor, Second Building, Second Floor, San José,
Overall rating
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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. He raised my hairline by at least half an inch, severely disfiguring me. I had to undergo a grueling 8.5 hour, $10,000 hair transplant surgery to restore my hairline. 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 honestly or honorably.