Extended "C" myectomy of the lateral orbicularis oculi muscle-A safe and successful method for treatment of "crow's feet".

[BACKGROUND] Commonly, patients who seek facial rejuvenation complain about "crow's feet." Botulinum toxin injections can effectively correct such wrinkles but require repeated treatments.

[OBJECTIVE] A modification of the earlier described vertical myectomy of the lateral orbicularis oculi muscle is presented.

[METHODS] The skin at the lateral orbit was elevated, using the temporal approach when performing a forehead or face lift, or medially when only a blepharoplasty was performed. The lateral portion of the orbicularis oculi muscle was identified and dissected. A portion measuring from at least 3 cm to 4.5 cm (average 3.1 cm) in length and averaging 1.1 cm in width was resected in a pattern designed as a reversed "C" A small part (approximately 3 mm) of the muscle was preserved medially to keep the orbicularis oculi muscle in continuity for preservation of the sphincter.

[RESULTS] All 28 patients treated in our series were free from relapse after follow-up ranging from 1 to 33 months. One patient developed a moderate hematoma that was treated successfully. Only 1 patient required additional fat grafting.

[CONCLUSIONS] The extended "C" myectomy of the lateral orbicularis oculi muscle achieves excellent results and is easily performed in conjunction with a face lift or blepharoplasty with negligible morbidity. Usually no fat grafting is necessary.