Crows foot wrinkles are common complaints in patients looking for facial rejuvenation. This work describes a new technique for a lasting treatment by partial lateral myectomy of the orbicularis occuli muscle. We operated on 19 women and 1 man, between 41 and 74 (average 55.7 ± 7.7). Surgery was associated with temporal region facelifts or blepharoplasty. All the operations were performed under local anesthetic and sedation, some of them by an anesthesiologist. A vertical rectangle strip of approximately 2 to 4 cm by 0.5 to 1 cm was resected in the lateral part of the orbicular muscle. The location was previously marked with the patient smiling and causing the wrinkles to appear. The removal of the muscle caused a depression in this area. This depression was filled with adipose tissue graft from the pre-auricular or temporal regions. In all cases we used a 4 x loupe to do the muscle resection avoiding damage on the underneath nerve fibers that innervated the remaining orbicular muscle. The result was immediate and all 20 cases have not shown relapse to date. No lid occlusion alterations was observed, even in the immediately post-op days. No related complication has been observed. Patient satisfaction and the effectiveness of the method are promising. The orbicularis occuli muscle is innervated by branch of facial nerve. This branches passes under the muscle. So, if we take care doing the muscle resection using a magnification instrument like a loupe, we will not damage nerves under the muscle and the procedure is very safe. In conclusion we believe that partial orbicularis occuli myectomy promotes the effective attenuation of Crows foot wrinkles.

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