Getting Rid Of Those Crow's Feet Lines

Getting Rid Of Those Crow's Feet Lines
Lines around the eyes give a variety of emotional
expressions, most of which convey a negative impression.
These periocular lines, or crow's feet as they are commonly
referred to, are the result of normal but excessive muscle
action of the underlying orbicularis oculi or sphincter
muscle of the eye.

As wrinkle lines form perpendicular to the action of the
encircling muscle around the eye, wrinkles develop and
radiate outward in a 'sunray' effect. Elimination or
softening of these lines is a frequently requested
procedure. While this request is simple, adequately
treating crow's feet often requires combination therapy.

Botox remains as the primary treatment method for the
crow's feet area. 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 necessay, 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.
Botox in combination with laser resurfacing can produce
some really significant results. Since the eyelids and the
surrounding skin is quite thin, it is an area that is
particularly reponsive to laser resurfacing. For most
patients that have a treatment focused on the crow's feet
area alone, we are not talking about deep laser surfacing.
Rather I use a light to moderate depth laser resurfacing so
that healing occurs quite quickly, usually within three to
five days. Laser depths around 35 to 50 microns (deep laser
resurfacing is around 200 - 300 microns) are easily
tolerated in the office under topical anesthetic cream, are
quick to perform, and require minimal post-treatment care.
The crow's feet area is pre-treated with Botox during the
same visit and then laser resurfaced. To keep the recovery
quick, the depth of laser penetration is keep limited.
Think about a series of these treatments done twice a year
to eventually get the best result.

Botox and light laser resurfacing are the principle methods
of treatment for crow's feet. Botox alone is a great
treatment for young patients given its prophylactic
effects. When laser resurfacing of the crow's feet skin is
needed, a good long-term result is only possible if the
underlying muscle action is controlled.

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Dr Barry Eppley, board-certified plastic surgeon of
Indianapolis, operates his private practice at Clarian
North and West Medical cenetrs in suburban Indianapolis. He
writes a daily blogs on topics and trends in plastic
surgery at http://www.exploreplasticsurgery.com