Myctomies on the face
Wrinkle-like wrinkles and wrinkles on the forehead have been treated with botulinum toxin injection. The results are very good, but of short duration, on average three to four months. Some patients, after some time, no longer have a result with botulinum toxin.
We developed, six years ago, a surgical technique with the aim of treating “crow’s feet” wrinkles and forehead wrinkles. This technique is called myectomy of the orbicularis muscle and frontal muscle.
The myoctomy of the orbicularis muscle, indicated for the treatment of “crow’s feet” wrinkles, can be performed with different approaches. The simplest of these is through a cut on the skin next to the eyes of about two centimeters. By this cut the lateral portion of the orbicularis muscle is removed. It can also be performed through surgery for the correction of excess skin on the upper or lower eyelid.
The myectomy may also be performed along with the temporal or facelift facelift. In the temporal facelift is used a cut in the region above the ear, next to the implantation of the hair. It is used to, in addition to the withdrawal of the orbicularis muscle, to make an elevation of the tail of the eyebrow.
When the patient presents flaccidity of the face, the myectomy is performed associated with the cervico-facial facelift. The cut is placed in front and behind the ear, and may or may not rise from the front of the implantation of the hair, in the temporal region. In this case it is all flaccidity of the face and also wrinkles “crow’s feet” through the orectomy myectomy.
Forehead wrinkles are treated by myectomy of the frontal muscle.
For this a strip is removed in the lateral portion of the frontal muscle. The cut to perform this myectomy is approximately two centimeters and is located inside the hair, above the forehead.
Anesthesia is usually local when in small procedures. When the procedure is larger, such as in the case of the cervico-facial lift, the anesthesia may be local along with sedation given by the anesthesiologist, or even general anesthesia, if the anesthesiologist feels that, depending on the anxiety of the patient, it is safer.
Recovery will depend on the procedure. When the myectomy is performed by direct incision, or by the eyelid, or by the temporal facelift, the recovery varies from one to two weeks. When the cervico-facial lift is performed, the recovery varies from two to three weeks.
Removal of these muscles leads to the long-term treatment of these wrinkles. Eventually, partial or total wrinkling may occur in this region, although this is rare. Once these muscles are removed, their replacement is impossible.
There may also be slight or moderate asymmetries, which can be corrected with a retouching, that is, a second procedure.
Depressions may occur in the areas where the muscles have been removed, which can be corrected with fat grafts performed in a second surgical procedure, although this is a rare occurrence.
Temporary or permanent changes in sensitivity to the scalp may occur in the frontal myectomy.
There is no contraindication if the patient has had previous surgeries.
There is no ideal age for myectomy, just as there is no minimum age or maximum age. When wrinkles appear and are bothering the person, the time is right.