Sun 31 Aug 2014
This question comes from a member of our hair loss social community and discussion forums:
I recently underwent hair transplant surgery. Everything went well, but I’ve experienced this strange “spasm” in my forehead since the procedure. I am wondering if it was from the local anesthetic; my doctor said he performed a “supraorbital and supratrochlear nerve block.” Is this normal? Do patients experience muscle spasms after hair transplant surgery?
First, and foremost, I think you should discuss this issue with your hair transplant surgeon. The doctor may have experience with this issue and offer an explanation to help put your mind at ease.
Muscle twitching in your forehead would likely be related to activity of the facial nerve (cranial nerve VII). During the procedure, it sounds like your doctor performed an anesthetic “block” of the supratrochlear and supraorbital branches of the trigeminal nerve (cranial nerve V). These nerves exit the skull directly above the midline of the eyebrow. The temporal branch of the facial nerve, which controls the muscles in the forehead (and would likely cause the spasm), is a bit deeper and further lateral compared to the trigeminal injection site. This means it would be difficult to accidentally inject or damage this nerve during the anesthetic block.
The other concern could be nerve issues during the strip extraction process of a Follicular Unit Strip Surgery (FUSS) procedure. However, the facial nerve exits the skull near the bottom of the ear, and this position makes it unlikely to be damaged during the strip extraction process.