This is very important because the frontal branch of the facial nerve underlies these muscle fibres and could be terminally damaged.

C

35

35

surgery we remove these wrinkles caused by the lat- eral fibres of orbicularis oculi muscle – theses are the cutaneous attachments of this muscle, and we can seal them with radiofrequency treatment, which does not produce overheating like a laser or electrocautery.

This is very important because the frontal branch of the facial nerve underlies these muscle fibres and could be terminally damaged.

Lateral to the canthus there are often radially spread wrinkles, especially if the patient smiles. It is possible to reduce these “smiling” wrinkles by Botox injec- tions – temporarily. For permanent removal, there is a possibility to treat them from outside through epi- dermal ablation with laser resurfacing or radiosurgi- cal, chemical, or mechanical peel (dermabrasion).

Bruce Connell has shown that we can mark these smiling wrinkles on the skin and by doing the facelift

Crow’s-Feet

Dimitrije E. Panfilov

Fig. 35.1. a Smiling patient before CO

laser resurfacing. b Immediately after the procedure

Fig. 35.2. Radiosurgical sealing of

cutaneous attachments of the orbicu-

laris oculi muscle

187 35 Crow’s-Feet

Bibliography

Please see the general bibliography at the end of this book.

Fig. 35.3. a Sterile markings over cutaneous attachments of the orbicularis oculi muscle. b Muscle attachments destroyed and

sealed by radiofrequency treatment. Another patient c before and d after such treatment