Orbicularis Oculi Myectomy Via Facelift or Blepharoplasty to Crow Feet Wrinkles Definitive Treatment and Facial Palsy Symmetrization.

Summary

Crow feet wrinkles are common complains in patients looking for facial rejuvenation. The vertical lateral myectomy of the orbicularis oculi muscle is a definitive treatment for those unaesthetic eyelid lines. This work describes the definitive treatment for crow feet wrinkles with of the orbicularis oculi muscle via facelift or blepharoplasty, comparing their results. We present 165 cases operated in the last 12 years.

Introduction

One of the first signs of ageing is the appearance of wrinkles around the eyes. The botulin toxin substantially reduces these wrinkles but is temporary. Surgical methods include exposure of the lateral border of the orbicularis oculi muscle, splayed out and sutured in this spread position, split laterally and the cut ends sutured separately. The objective is present a new method, the vertical lateral orbicularis oculi myectomy, via facelift or blepharoplasty.

Method

We operated 165 patients between 28 and 76 years old (average 52.2 ± 10,5). The myectomy was made via temporal region facelift or via blepharoplasty. The number of patients that underwent to facelift were 132 patients, between 33 and 76 years old (average 52,7± 8,9) and blepharolasty were 33 patients, between 28 and 76 years old (average 48.16 ± 9.7). During face lifting, we elevated the skin in the temple and at the orbit. A vertical rectangle strip of approximately 1 to 5.5 cm (average 3.78) by 0.8 to 2.5 cm (average 1.52) was removed in the lateral part of the orbicular muscles.

During upper or lower blepharoplasty, the para-orbital skin is elevated and the vertical rectangle strip removed. The removal of the muscle causes a depression in this area. This depression is filled with adipose tissue graft from the pre-auricular (SMAS), temporal subcutaneous or lower abdomen. Recently we have used aspirated fat.

Results

Even via facelift or blepharoplasty the improvement was immediate and all cases have not shown relapse to date. No related complication has been observed. No major problems were observed, even in the immediately post-op days. In both cases, the patient satisfaction and effectiveness of the method are promising. The analysis of aesthetic results showed vertical lateral myectomy of the orbicularis oculi muscle via temporal lifting is superior than via blepharoplasty.

Conclusion

Vertical lateral orbicularis oculi myectomy effectively and definitively reduces crow feet wrinkles.