Is the Orbicularis Oculi Muscle Ever Frozen with Botox Injections?

Question

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."

John Bitner, MD · Answer

Botox is FDA approved for cosmetic purposes only in the glabella. However, it is commonly used "off label" in other locations.  I commonly inject it on the side of the eyes, partially weakening the lateral extent of the orbicularis oculi muscle. This helps to soften crow's feet when smiling.  When used here, I have never seen it create an un-natural or fake appearance with facial animation.

Ron Shelton, MD · Answer

To minimize and soften the crows feet lines, the Botox is purposefully injected into the outer corner of the eyelid to affect this muscle. This is the muscle that allows us to squint and most people can squint voluntarily so I disagree with the statement to which you referred in the article.

Sanusi Umar, MD · Answer

Botox would weaken the outer portions of the orbicularis occuli to reduce / improve crows feet. It is true that crows feet treatment may not result in complete resolution. This is because when we smile, our cheeks would elevate independent of the activity of the orbicularis. Thus you might have some residual crows feet formation upon smiling even if botox has done its part of weakening the outer posrtions of the orbicularis oculi.

Daryl K. Hoffman, MD · Answer

Yes, the orbicularis oculi muscles are often "frozen" with Botox to treat crows feet lines.  That muscles is the one that closes the eyes, so the whole muscle isn't frozen, just the part infer the crows feet. I do believe that the smile of true delight shows much differently than a fake smile. Artfully done Botox shouldn't change that.

Kenneth D. Steinsapir, MD · Answer

When we smile we do activate the orbicularis oculi muscle on the top of the cheek.   Over  treatment with Botox will affect the activity of the orbicularis oculi muscle.  In fact over treat with Botox will create a frozen or locked in effect which is aesthetically undesirable.  The goal of Botox should be the subtle and favorable adjustment of the balance in facial muscles.  This the reason why I introduced Microdroplet Botox.  This patented method creates a forehead lift without the paralysis associated with many treatment patterns.

Richard Baxter, MD · Answer

The eyes and the mouth have a circular muscle around them called orbicularis, which puckers the lips (causing "smoker's lines") and crow's feet wrinkles lateral to the eyes. Botox works well for crow's feet when palced into the lateral part of the orbicularis oculi. Keep in mind though that smiling involves a lot of muscles (not as many as frowning according to popular wisdom) so you shouldn't lose all expression by treating the orbicularis with Botox.

Steven Wallach, MD · Answer

Quite often patients have the crow's feet treated which consists of injecting Botox into the orbicularis muscle which makes up the crow's feet region.

Ted Brezel, MD · Answer

The orbicularis muscle is treated when we treat the crow's feet with Botox and when one attempts to get a slight lift of the brow. I think Dr Smith said it well, our goal is not to freeze the muscle but to relax the muscle to achieve a more relaxed look.

Louis W. Apostolakis, MD · Answer

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.

Peter A. Aldea, MD · Answer

What makes us APPEAR human is our ability to show facial expressions. The muscles of facial expressions, also called ANIMATION muscles are so named based on the Latin word of Anima or Soul. It is therefore an outward expression of our soul to facially express our inner feeling and emotion. 

	Unlike what Oprah.com states, the Orbicularis Oculi muscle CAN and IS moved deliberately every time we smile, forcibly close our eyes or squint. The repeated contractures of the muscles crease the skin creating the Crow's Feet deformity. This is similar to what happens when a lawn bag cinching plastic cable is pulled closing the bag but creasing the bag around the closing opening. Placing a few units of Botox around the lateral aspect of the eye weakens the Orbicularis Oculi muscle in this area and by it being unable to fully contract, it cannot create the pleats and wrinkles of Crow's Feet.

	Conclusion? - Don't believe everything you read, even on Oprah.com. Do your own research.

Is the Orbicularis Oculi Muscle Ever Frozen with Botox Injections?

Answers (14)

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