Freshing Up Those Eyelid Wrinkles

The development of radiating lines, or crow’s feet, around the eye is a stigmata of facial aging. They are the result of near continual muscle action of the sphincter muscle of the eye, known as the orbicularis oculi.

As wrinkle lines form perpendicular to the action of the encircling muscle around the eye, wrinkles develop and radiate outward in a ’sunray’ effect. Treatment of crow’s feet problems is a frequent inquiry. While this request is simple, adequately treating crow’s feet often requires combination therapy.

The main treatment for crow’s feet is Botox injections. Trying to remove these wrinkles without reducing their muscular action will produce disappointing results. Three injections sites for each side will usually suffice, placing them along the lateral orbital rim from below the eyebrow to the body of the zygoma. I never inject below the zygoma for fear of causing paralysis of the upper lip. Most patient’s will have a large vein or two in this area so it is important to avoid these and stay further temporally if necessary, otherwise a nice large bruise will result which will take weeks to go away. A total of 10 to 12 units of Botox per side is usually an adequate dose. For the younger patient without established crow’s feet wrinkles, the use of Botox will be completely preventative if treatments are maintained.

For the older patient who at rest already has established crow’s feet wrinkles, combination therapy will be needed. The combination of muscle weakening (Botox) and skin resurfacing (laser) can make some real dramatic changes over time. Read the rest of this entry »