Brow lift for facial paralysis or synkinesis

Facial paralysis can result in drooping of the eyebrow. This can be severe enough in some cases to cause obstruction of vision in that eye.  To treat this visual obstruction and improve the symmetry of the eyebrows, a brow lift can be performed. The most common means of lifting the brow in facial paralysis are either a direct brow lift, where skin is removed just above the eyebrow, or an endoscopic brow lift, where the brow is elevated using an endoscope. Small incisions placed in the hair-bearing scalp.  An endoscopic browlift is particularly helpful for the treatment of synkinesis, if the abnormal facial movement affects the eyebrow region. A patient who had a facelift performed by Dr. Pepper is shown in Figure 1 and Figure 2. Brow lifts take about 1.5 – 2 hours to complete and usually require general anesthesia, depending on the technique chosen. For recovery, we recommend two weeks off of work.  Expect that swelling and any bruising will resolve in 2 or 3 weeks.

Figure 1: a patient of Dr. Pepper’s, before and after endoscopic brow lift performed for left eyebrow synkinesis.  Her face is relaxed. Note the symmetric brow position in the after photo, seen at right.

Figure 2: before and after endoscopic brow lift performed for left eyebrow synkinesis, with eyes closed. Note the softer muscle contractions in between the brows in the image on the right.