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Aesthetic and Non-aesthetic Indications for Orbicularis Oculi Myectomy

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Abstract

Introduction

Crows’ feet wrinkles are caused by the action of the orbicularis oculi muscle on overlying skin. Treatment options range from botulinum toxin to a multitude of surgical methods. We first described our technique in 2003 and refined it in 2006. We highlight the evolution of our technique and look at our results to assess the effectiveness of our technique.

Objective

The aim of this article is to show our experience of 13 years in 134 patients with our technique of orbicularis oculi myectomy.

Methods

From September 2000 to July 2013, we operated on 134 patients with an age range of 28–77 years. Of these patients, 104 had myectomies via lifting and 22 via a blepharoplasty approach. Five patients had myectomies for treatment of blepharospasm and a further three patients to restore symmetry in facial palsy. An evaluation of the results was performed by two medical students.

Results

Our results showed reduction of the wrinkles in all cases. For the statistical analysis the Wilcoxon test was performed. The p value was less than 0.001 showing a significant reduction of crows’ feet wrinkles in both sides when the orbicularis myectomy was performed, via blepharoplasty or lifting. For myectomy performed for blepharospasm or facial palsy, the statistical analysis was not done due to the low numbers.

Conclusion

In the appropriate patient, orbicularis oculi myectomy is an effective and long-term treatment for crows’ feet wrinkles with a low risk of complications and high patient satisfaction.

Level of Evidence IV

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References

  1. 1.

    Pitanguy I (2012) Facial rejuvenation surgery: a retrospective study of 8788 cases. Aesthet Surg J 32(4):393–412

  2. 2.

    Park DH, Han DG, Shim JS, Lee TJ, Park SU, Do ER, Choo KJ (2012) Analysis of the patterns of lateral canthal rhytids and reference for botulinum toxin treatment in orientals. Aesth Plast Surg 36:1211–1215

  3. 3.

    Lemperle G, Holmes RE, Cohen SR, Lemperle SM (2001) A classification of facial wrinkles. Plast Reconstr Surg 108:1735–1750

  4. 4.

    Tsukahara K, Osanai O, Kitahara T, Takema Y (2013) Seasonal and annual variation in the intensity of facial wrinkles. Skin Res Technol 19:279–287

  5. 5.

    Cula GO, Bargo PR, Nkengne A, Kollias N (2013) Assessing facial wrinkles: automatic detection and quantification. Skin Res Technol 19:e243–e251

  6. 6.

    Fujimura T, Hotta M (2013) A novel method to investigate the relationship between facial movements and wrinkle formation using particle image velocimetry. Skin Res Technol 19:e54–e59

  7. 7.

    Carruthers J, Carruthers A (2009) Botulinum toxin in facial rejuvenation: an update. Dermatol Clin 27(4):417–425

  8. 8.

    Skoog TG (1974) Plastic surgery: new methods and refinements. Saunders, Philadelphia

  9. 9.

    Aston SJ (1980) Orbicularis oculi muscle flaps: a technique to reduce crows feet and lateral canthal skin fold. Plast Reconstr Surg 65:206–216

  10. 10.

    Connell B, Marten T (1993) Surgical correction of the crow’s feet deformity. Clin Plast Surg 20:29

  11. 11.

    Camirand A (1993) Treatment of dynamic crow’s feet while performing a blepharoplasty. Aesthet Plast Surg. 7:17

  12. 12.

    Bonatto A, Freitas AG, Mélega JM (2002) Myectomy of the orbicularis oculi muscle: a new procedure associated to blepharoplasty. Rev Soc Bras Cir Plast Sao Paulo. 17:27

  13. 13.

    Aston SJ (1981) Orbicularis oculi muscle flaps: a follow-up of the technique to reduce crow’s feet and lateral canthal skin folds. Clin Plast Surg 8:679–686

  14. 14.

    Fogli AL (1995) Orbicularis muscleplasty and face lift: a better orbital contour. Plast Reconstr Surg 96:1560–1570 discussion 1571–1572

  15. 15.

    Cabbabe SW, Andrades P, Vasconez LO (2009) Lateral orbicularis oculi muscle plasty in conjunction with face lifting for periorbital rejuvenation. Plast Reconstr Surg 124(4):1285–1293

  16. 16.

    Guerrissi JO (2010) Periorbital rejuvenation: a safe subcutaneous approach to forehead, eyebrow, and orbicularis oculis muscle mobilization. Aesthet Plast Surg 34(2):147–152

  17. 17.

    Viterbo F (2003) New treatment for crow’s feet wrinkles by vertical myectomy of the lateral orbicularis oculi. Plast Reconstr Surg 112:275

  18. 18.

    Viterbo F, Lutz BS (2006) Extended “C” myectomy of the lateral orbicularis oculi muscle—a safe and successful method for treatment of “crow’s feet”. Aesthet Surg J 26:131–135

  19. 19.

    Carvalho F, Silva V, Moreira A et al (2008) Definitive treatment for crow’s feet wrinkles by total myectomy of the lateral orbicularis oculi. Aesthet Plast Surg 32:779

  20. 20.

    Ryu MH, Shin Y, Kahng D (2014) The surgical correction of crow’s feet deformity with radiofrequency current. Aesthet Plast Surg 34:28

  21. 21.

    Park YJ, Jo YW, Bang SI et al (2007) Radiofrequency volumetric reduction for masseteric hypertrophy. Aesthet Plast Surg 31:42

  22. 22.

    Ryu MH, Kahng D, Shin Y (2014) Surgical correction of crow’s feet deformity with radiofrequency current. Aesthet Surg J. 34(1):28–33

  23. 23.

    Connell BF, Marten TJ (1993) Surgical correction of the crow’s feet deformity. Clin Plast Surg 20(2):295–302

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Acknowledgments

We thank Dr. Antonio Graziosi for the revision of the text. We also thank Eduardo Leite Fonseca and Larissa Pierri Carvalho for the evaluation of the pictures.

Author information

Correspondence to Fausto Viterbo.

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Disclosure

The first author receives royalties from Doctus Company that produces the Viterbo’s dissectors.

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Viterbo, F., Joethy, J. & Brock, R.S. Aesthetic and Non-aesthetic Indications for Orbicularis Oculi Myectomy. Aesth Plast Surg 40, 466–474 (2016). https://doi.org/10.1007/s00266-016-0638-5

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Keywords

  • Crows’ feet wrinkles
  • Orbicularis oculi
  • Myectomy
  • Botulinum toxin