Thank you for your question. You are asking if crow’s feet lines can be treated with
a facelift and I certainly understand why you are asking this question. A little bit
of background, I’m a board certified cosmetic surgeon and fellowship trained oculofacial
plastic and reconstructive surgeon. My expertise is in facial aging as well as advanced treatment
of the area around the eyes and I’ve been in practice for over 20 years in Manhattan
and Long Island.
As far as the question about crow’s feet lines is concerned, there is invariably the
natural instinct to just pull and say well just, “Doctor, can you pull and tighten
this?” And the problem is that crow’s feet lines is really a combination of factors
depending on two key elements: and one is the activity of the muscle around the eye
responsible for the contraction of the skin and looseness or laxity of the skin around
the eyes.
So first, let us start first with the assumption the skin is not lax around the eye and there
isn’t eyebrow ptosis. What is causing the crow’s feet line is the muscle called orbicularis
oculi muscle and this muscle contracts and when they contract, it causes these lines
to form. So the traditional approach to this is a drug called Botox™ as well as the comparable
drugs such Dysport and Xeomin . Basically, you are stopping the muscle from contracting
and by doing that, the crow’s feet lines improve. In addition to that, if you have
static lines which is not unusual, then it is typical for us to also do a treatment with
a laser such as a Fractional CO2 Laser or Erbium laser to resurface the skin as well
as tighten the dermis to improve the quality of the skin and improve the appearance of
Crow’s Feet lines.
Now, there are times when a person has eyebrow ptosis where the eyebrow can be lifted and
you can actually reduce some of the skin that has descended and it is contributing to the
depth of those lines. Interestingly, prior to the advent of these injectables and lasers,
there are procedures in our medical literature about actually cutting out this muscle to
help reduce the crow’s feet lines but I think most of my colleagues would not pursue
that method given the technologies and methods that they have.
Crow’s feet lines, because of the multiple factors contribute to them, a facelift in
you doesn’t really address this area. In fact, a facelift really addresses the descending
cheek and jowls. So when you think of it, you are actually moving in a direction that
doesn’t really affect directly the crow’s feet lines. Now, if you make the incisions
go high into the hairline, you can somewhat improve the appearance but still the skin
vector will not be enough really to flatten the area. You can get some improvement but
as I said, it’s more about the upper part of the face that can affect the appearance
of the crow’s feet lines.
But in the end, I would recommend or I would describe what we would typically do in our
practice if someone is concerned about the lines around their eyes, we would do some
type of combination of like Botox™ and resurfacing and as well as platelet-rich plasma (PRP)
which can help improve the skin quality and synergize the benefit of laser procedures.
So again understanding that the facelift is really about the mid to lower face and that
lift would not directly affect the appearance of the crow’s feet lines and that the medical
procedure like lateral or temporal brow lift can indirectly improve the some redundant
skin that has contributed to the crow’s feet lines. But in the core principle of the
activity of this area, of this compartment or section of the face, you are dealing with
the orbicularis muscle that can be treated with Botox™. And you are dealing with skin
quality which can be improved by a combination of laser as well as platelet-rich plasma (PRP).
So I hope that was helpful, I wish you the best of luck and thank you for your question!