Abstract
Bilateral facial nerve palsy is an exceedingly rare condition. Sequelae caused by facial paralysis, including facial deformity, visual field disturbance and drooling, can have significant functional, aesthetic and even psychological impacts. We report an unusual case of a 49-year-old Japanese woman with visual field disturbance associated with brow ptosis by bilateral facial nerve palsy. Treatment involved brow lift after the failure of conservative measures. Various methods of brow lift have been reported, but midforehead lift was used in this case to sufficiently elevate the medial brow and glabellar ptosis. At the one-year follow-up examination, there had been no recurrence of brow ptosis, and the patient was satisfied from psychological, aesthetic and functional perspectives. We recommend this procedure because it is simple, effective and safe for a single plastic surgeon to perform without the need for special equipment. In cases of brow ptosis due to bilateral facial nerve palsy, especially in middle-aged and elderly patients, a midforehead lift seems to be a reasonable treatment option. Further cases are needed to confirm these benefits.
(a) At the level above the lateral brows, the width of the area to be excised was approximately 20 mm, and in the middle area of the glabella, it was approximately 15 mm. This was designed so that most of the final scarring would be located within the furrow line. (b) The wound was meticulously closed in layers.
