Permanent removal of crow's feet by removing certain segments of orbicularis muscle? Is it safe? What's the cost and recovery?

Question

I have bad crow's feet. Getting Botox every 3 months for the rest of life doesn't seem ideal. I'd prefer something permanent. One doctor has on his website, "After studying the various muscle segments which cause skin tightening around the eye, Dr. has discovered that by removing certain, carefully measured, segments of the orbicularis muscle, a permanent reduction or utter elimination of Crow’s-feet can be achieved." Do doctors really do this?

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello Shelly,  I would be very cautious about any permanent removal of your orbicularis oculi muscle.  It is a sphincter-type muscle that allows you to close your eye, thereby facilitating hydration and moisture of the eye.  I would be concerned about those other functions when considering permanent excision of any segment of orbicularis.Good luck.Mark K Markarian, MD, MSPHHarvard-trained Aesthetic Plastic Surgeon

Tanveer Janjua, MD · Answer

It is not safe to remove orbicularis muscle as in some cases the nerve going to the upper part of it gets cut and you will not be able to close your eyes. You are better off undergoing ThermiRase.RegardsDr Janjua

Reza Momeni, MD, FACS · Answer

This is not a common procedure due to concern for viability of the skin afterwards and also for the function of the nerve that helps close your eyelids.  I would not recommend such a procedure to my patients.

Walton Montegut, MD · Answer

The orbicularis is a circular muscle around the eye which is the source of crow's feet.  As this muscle contracts, it creates the lines named crow's feet.  There is a way to decrease this action and the muscle can be divided on the lateral aspect of the eye to soften the effect.  The time to do this procedure is while undergoing a Facelift.  During a facelift, the muscle is exposed and can be divided at this time.  There is the possibility of a nerve injury if the surgeon is not skilled in this surgical maneuver.  However, if a patient has severe crow's feet, this improvement should be performed at the time pf a facelift.  When divided, it significantly improves the appearance of the crow's feet.  I routinely perform this maneuver during a facelift to achieve this improvement.  it tends to be difficult if not undergoing a facelift due to exposure.  other than this, BOTOX is the best solution.  I hope this helps.

Steven Wallach, MD · Answer

The orbicularis is a ring of muscle around the eye. Sometimes during facelifting, the ring of muscle can be split. This allows the brow to elevate a bit and can relax the crow's feet a bit.

Damon B. Chandler, MD · Answer

There are no ideal solutions in 2017 for permanent removal of crow's feet. The orbicularis oculi muscle is vital to normal functioning of the eyelids.  During certain eyelid procedures it is true that portions of the orbicularis oculi muscle can be tightening, moved, or even excised. But removal of the orbicularis under the crow's feet is fraught with challenges. In addition, removing muscle will not change any ingrained, permanent alterations of the skin which may have already occurred from aging. I would not advise this particular procedure for my patients. Also, make sure that you are only being seen by a board-certified, fellowship-trained MD Oculofacial Plastic Surgeon with particular expertise in cosmetic eyelid surgery -- avoid doctors that do eyelid surgery part-time. Best of luck.
Damon B. Chandler, MD
Harvard-Penn Trained Oculofacial Plastic Surgeon

Brooke R. Seckel, MD, FACS (retired) · Answer

The orbicularis oris oculi muscles that cause crow's feet have very important functions designed to protect the eye and prevent dryness.  I would be very cautious and would not remove any of the orbicularis oculi muscles.

Permanent removal of crow's feet by removing certain segments of orbicularis muscle? Is it safe? What's the cost and recovery?

Answers (7)

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