The wrinkling you are describing are secondary to repetitive muscle movement and changes of the skin during the aging process. These lines are not secondary to sagging tissue or loss of volume in the face. Due to these reasons, lifting the skin during the facelift will not improve these lines.The only way to improve these areas are to limit movement in this area with treatment of Botox or improve the quality of skin. The skin can be improved by variety of skin treatments including lasers, chemical peels, or micro-needling treatments.I hope this helps
Good question. Botox is often the best way to treat wrinkles or crow's feet around the eye. Sometimes I have divided the muscle ring around the eye by the lateral corner to soften the wrinkles. It also can elevate the tail of the eyebrow.
The wrinkles around your eyes when
you smile are due activity of the underlying muscle that surrounds your eyes,
as well as the loss of elasticity of your skin that occurs with age, so that
when the skin is lifted with a smile the skin wrinkles rather than tightens. BOTOX
reduces the activity of the muscle around your eyes, and is effective for crow's
feet, but with a very wide smile, the muscles that pull your cheek up can still
result in wrinkles. Pulling your skin back with your fingers will give the
appearance of improvement, but there will be enough skin relaxation and
stretching after a facelift that the improvement in those wrinkles would be
very temporary. Separating the skin from the underlying muscle around the eye
can help crow's feet, but I would not recommend surgery to achieve that one
goal: it is too much for that isolated goal. I hope this information helps.
A facelift does not address crows feet wrilkles and usually botox is the simplest treatment option. Resurfacing - i.e. lasers / peels / dermabrasion can be other alternatives but facelifting will not help and botox would most likely give you the most reliable result.
Thanks for your question, DZB. It's a fairly common
misconception that facelift surgery treats the entire face. In reality, a
traditional facelift lifts and tightens only the lower two-thirds of the face,
which is where most people show their earliest and most significant facial
aging. Your crow's feet can definitely be effectively treated by BOTOX — in
fact, the treatment of crow's feet is one of its main cosmetic indications.
Occasionally, it takes some trial-and-error to hit the right dose. Laser and
energy treatments can also help with fine wrinkles. If you are in search of a
surgical solution, you would achieve better results with eyelid surgery.
It appears as though Botox will give you nice results. A facelift is nice, but I would have to see you in person in order to make this recommendation for you.
The wrinkling you notice when smiling is caused by contraction of the underlying muscle, as most of the experts have commented here. However, this is exacerbated by any laxity in the overlying skin. I agree, tightening the skin does help alleviate the wrinkles caused by the muscle. You have demonstrated this clearly with a slight pull with your fingers. The question is, is it worth the scars and rather invasive intervention of a temporal lift. And, if a temporal lift does effect some modest alleviation of those wrinkles, we will they simply recur as the skin settles and stretches several months after the procedure.
I think a more judicious approach to your case, given that you do not like the effect of Botox, is to try some form of laser skin tightening. There are several machines and lasers out there which can achieve this. This may give you some of that alleviation with out the invasiveness of a surgical procedure.
Talk to a board certified plastic surgeon.Best of luck!
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA
I can certainly appreciate your frustration when it seems like such a simple pull corrects your problem. The issue is surgery addresses sags and bags. It does not address active muscles. This is addressed with neuromodulators such as Botox or Dysport or Xeomin. For the crow's feet area, the wrinkles are caused by a muscle that goes around the eye. Every time you smile, that muscle contracts and worsens the wrinkle. This active muscle needs to be treated with a neuromodulator. If the wrinkle remains at rest after a neuromodulator, you can consider resurfacing procedures such as a chemical peel or laser to further help soften the wrinkle although it would be unlikely to completely remove the wrinkle.
I hope this helps and good luck.
Botox or Dysport is indeed the best answer for your problem. However, the skill of the injector and his/her knowledge of facial anatomy is of utmost importance. Paralysis of the lateral orbicularis muscle is possible without affecting the muscles that control your smile. I suggest you seek the advice and evaluation by a board certified plastic surgeon.
Unfortunately surgery has limitations and trade-offs - there are things that simply cannot be done safely, and all surgery has unwanted 'side-effects.' What you are seeing is a result of muscle activity, so the treatment is to reduce the muscle activity - this is best done with botox. It is very common to need to 'titrate' the botox dosages and injection locations to get the ideal result in a given patient - I would suggest visiting with a board-certified plastic surgeon and discussing your goals in details. I have confidence that an experienced injector could achieve your goals without causing significant changes in your smile. Good luck!