Removal of Muscle Helps Correct Eye Wrinkles
By: Anna Nidecker, Staff Writer
NEW ORLEANS — Removal of part of the muscle surrounding the eye helps correct crow’s-feet, said Dr. Nikolas V. Chugay, a cosmetic surgeon in Long Beach, Calif.
The effects of this procedure last longer than more superficial procedures for smoothing out deep lines around the eyes, such as Botox injections and laser resurfacing, he said at the annual meeting of the American Academy of Cosmetic Surgery.
“I’ve seen some patients 5 and 6 years later, and they don’t have any recurrence of marked crow’s-feet,” Dr. Chugay commented.
His technique involves a crescent excision of the orbital aspect of the orbicularis oculi muscle.
An endoscopic approach requires only a very small incision to go in and remove this portion of the muscle, said Dr. Chugay, who has performed over 500 of these procedures.
He makes the incision in the temporal region of the hair-bearing area with a number 15 Bard-Parker blade. The incision provides access to the orbicularis oculi and can be used to perform a simultaneous face or forehead lift. He performs a blunt dissection under the skin to the level of the orbicularis oculi muscle. The orbital portion of the orbicularis oculi muscle is excised on the lateral aspect of the muscle with a forceps and scissors.
The temporal flap, if made, can then be put back in position and excess skin resected. Tissues are closed in layers. Dr. Chugay cautioned that the procedure does not completely remove crow’s-feet, and some patients would benefit from postoperative laser resurfacing to smooth out stubborn wrinkles. Complications of this procedure included a single case of alopecia in the temporal area and one hematoma. Dr. Chugay suspected that the case of alopecia was the result of too much tension in the temporal flap when the procedure was done in conjunction with face and forehead lifts.
The hematoma case resolved with a postoperative needle aspiration, he commented.