Austin Doctors

Is the Orbicularis Oculi Muscle Ever Frozen with Botox Injections?

I read the paragraph below on an Oprah.com article, and was wondering if this muscle is commonly or ever frozen by botox injections? "When someone smiles out of genuine delight, a facial muscle called the orbicularis oculi involuntarily contracts, crinkling the skin around the eyes. Most of us are incapable of deliberately moving this muscle, which means that when a person fakes a smile, her orbicularis oculi likely won't budge."

I have not looked at Oprah's explanation, but it is not true that the orbicularis muscle is inactive during a fake smile.  It is very easy to voluntarily activate that muscle and a fake smile would most certainly include the orbicularis.  In fact, it would require a great deal of concentration to fake a smile and not use the orbicularis muscle to any appreciable degree.  It is true that a faked smile is different than a real smile, but it has to do with the fine details of the activation and includes all of your smile muscles, not just the orbicularis.

Botox could be used to fully disable the orbicularis muscle.  But this is never done.  You only treat the portion in the Crow's foot area.  If you were to disable the entire muscle, you would not be able to close your eyes except by passive "spring" of the tissues and gravity.  This is seen in people after nerve injuries or strokes and it can be very dangerous to the health of your eye.

Louis W. Apostolakis, MD

Austin Facial Plastic Surgeon

Do I Need a Lift? I Just Want Implants. (photo)

Hi i am terribly upset, i have had my consultation today and have been told i need a lift! i am only 20 and am not prepared to have the lollypop scars as i really feel i dont need a lift. I am after a small D cup hopefully (but would be content with a c) I just want a much rounder look. Round and fake looking but not set high up on my chest.

From your photo it's clear that your right breast is a little larger and that the nipple hangs lower. To fix this and get a more symmetric result most plastic surgeons would reccomend a breast lift. It's quite possible that this lift could be accomplished with scars only around the areola but it's impossible tell for sure without examining you. Periareolar scars heal very well and should not really be something to be fearful of. The problem with just placing implants is that the shape will never be right. Fixing the breast size and nipple height discrepancy is the best way to make you happy--even if it means a few extra scars and perhaps some extra costs for more surgery time. At my Austin, Texas area plastic surgery practice I often have young patients like yourself that are afraid of the scars after a breast lift, but I will tell you that after surgery they are always really glad that we took the extra steps to make their breasts more symmetric. I often talk about breast lifts as if they are vegetables your kids don't want to eat. You may not like them initially but in the long run they are in your best interest. I'd go see a few more board certified surgeons and realize that the advice you were given yesterday is probably good. Best of luck, Dr. Kerr Breast lifts.

Mahlon Kerr, MD

Austin Plastic Surgeon

Are Implants Ok to Get for Someone Who is 24 Years of Age?

I am 24 years old. I am now a 34B i have wonderful curves and backside, however I am not happy with my breast size. Is there anything that i can do to increase my breast size without surgery?.. if so would the side effects be dangerous?

DDivine,

You sound like a great candidate for breast augmentation.Depending on how big you want to go, you probably will not require very large implant, and as a result, you will look very natural- especially if you go with silicone gel implants. I know of no other way to increase your breast size in a controlled fashion.

William H. Gorman, MD

Austin Plastic Surgeon