Most people who have a forehead lift are happy with the result. Still, there are several things that can go wrong. No matter which method of surgery is used (open or closed) similar risks can occur. This is a list of some of the possible problems.
Bleeding and hematoma: this can be anything from excessive bruising to a collection of blood called a hematoma. A hematoma may call for more surgery. Bleeding is more common in men.
Nerve injury: both motor (nerves that cause muscles to move) and sensory (feeling) nerves can be damaged during a forehead lift. Damage to the motor nerves may cause weakness of a part or all the forehead or scalp. If a sensory nerve is cut, it produces numbness and sometimes chronic pain because of neuroma formation. Patients sometimes complain of unusual nerve feelings (paresthesias) like itching or pins and needles.
Swelling or edema: there is always some swelling after a forehead lift but a small group of patients develop persistent swelling that may take several weeks to resolve.
Infection: because of the excellent blood supply of the head and neck infection is very rare after a forehead lift. However it develops it can be a serious complication It is more common if a hematoma develops.
Loss of skin: necrosis or loss of skin can happen after a forehead lift. It is most common in smokers and may be the result of a hematoma.
Changes in the scalp: during surgery the skin is stretched and this can cause some changes in the scalp itself, including loss of hair and persistent bruises.
Heavy scar: the incision is usually well hidden and not a problem. If it becomes thicker, it is more noticeable. It is most likely to be heavy when it is closed under tension. Scar revision is sometimes needed.
Wide scar: if the scar stretches and become wide it may be seen through the hair. Hair does not grow in scars.
Changes in the hair: alopecia or loss of hair can develop in areas where there is undermining or separation of scalp from the deep tissue. This can damage the hair follicles. When the skin is pulled back, it can also change the hairline.
Unnatural appearance: when the skin is pulled and the muscle function weakened it is possible that facial expression may be changed and this can look unnatural. If strips of muscle are removed surface depressions may also be seen.
Early recurrence: in older patients, and those with poor elasticity, the results may be satisfactory or even dramatic but they may not last very long. Early secondary surgery is sometimes needed. Unless warned of this in advance these patients may be disappointed with their result.
Dissatisfaction with result: not everyone who has a forehead lift likes the result but fortunately for patient and doctor, most people are glad they had the surgery
Lagophthalmos: if the patient has an upper lid blepharoplasty with a forehead lift it is possible for too much skin to be removed. This prevents the eyelids from closing and may cause corneal ulcers or other eye problems.