Orbicularis Oculi Muscle Resection for Crow's-Feet Rhytids

Abstract

Introduction: Crow's-feet rhytids are a common sign of aging. The deformity is produced by smiling and becomes persistent with dermal collagen shortening and skin laxity during the aging process. It was hypothesized that resection of the lateral orbicularis oculi muscle (OOM) would result in permanent loss of the rhytids lateral to the eyes. Materials and Methods: A retrospective analysis was made of 14 patients who had resection of a beveled crescent of the OOM between September 1993 and September 1996, either as a primary procedure or during a face-lift or brow-lift. Local anesthesia with intravenous sedation was used. Results: Each of the patients had marked improvement or complete resolution of the lateral eye rhytids. The only complication was temporary temporal alopecia following a concurrent forehead–brow lift. Discussion: Medical therapy for crow's-feet rhytids has included injections of collagen, fat, silicone microdrops, and Botulinum Toxin A as well as application of chemical peels, laser, retinoids, and vitamin A. Permanent resolution of the rhytids does not occur with these modalities. Surgical manipulation of the OOM with splitting and suturing techniques have resulted in only minimal success. Beveled crescent resection of the lateral portion of the OOM has eradicated or markedly improved the crow's-feet over a follow-up period of 1 to 51 months.