Orbicularis oculi selective-denervation (OOSD): A secondary long-term effect for crow's feet reduction following temporal subcutaneous brow lift with orbicularis repositioning.

Abstract

In the last decades various authors have experimented and described more invasive techniques for manipulation of the orbicularis muscle to surgically reduce crow's feet. Nevertheless, scientific literature still has too few articles reporting experience with these surgeries leading to the inability to determine which is the most effective technique. The aim of the study was to report surgeons' experience based on one hundred ninety four cases of orbicularis oculi selective-denervation with crow's feet correction following temporal subcutaneous brow lift with orbicularis repositioning and Temporal MORE (Modified Orbicularis REpositioning). Furthermore, an overview of the anatomical evidences on the orbicularis oculi muscle was illustrated. The authors included in this study one hundred ninety four consecutive patients who underwent temporal subcutaneous brow lift with orbicularis repositioning or Temporal MORE with a minimum follow-up of two years. An evaluation of the pre- and post-operative photos was performed by a jury composed of 3 independent plastic surgeons basing on the Merz five-point dynamic Crow's Feet Grading Scale. Statistical analysis was conducted with Prism9. Of the 194 analyzed cases, the 182 (93.81%) patients who had an initial score greater than or equal to 2 had a score at the first postoperative time (T3) of 0 or 1 showed a statistically significant reduction in score between T0 and T3. No statistically significant difference between T3 and T12 and between T12 and T24. Temporal subcutaneous lift with orbicularis reposition and Temporal MORE allow crow's feet relaxation providing long-term results due to OOSD.