Myectomy

Myectomies on the face

Wrinkles like ‚Äúcrow’s feet‚ÄĚ and forehead wrinkles 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 show results with botulinum toxin.

Six years ago, we developed a surgical technique to treat wrinkles like “crow’s feet” and forehead wrinkles. This technique is called myectomy of the orbicularis muscle and frontalis muscle.

Myectomy of the orbicularis muscle, indicated for the treatment of ‚Äúcrow’s feet‚ÄĚ wrinkles, can be performed with different approaches. The simplest of them is through a cut in the skin next to the eyes of about two centimeters. This cut removes the lateral portion of the orbicularis muscle. It can also be performed through surgery to correct excess skin on the upper or lower eyelid.

Myectomy can also be performed in conjunction with a temporal facelift or cervico-facial facelift. In the temporal lifting, a cut is used in the region above the ear, along with the implantation of the hair. In addition to removing the orbicularis muscle, it takes advantage of an elevation of the eyebrow tail.

When the patient has flaccidity of the face, myectomy is performed in association with a cervical-facial lifting. The cut is placed in front of and behind the ear, and may or may not go up in front of the hair implant, in the temporal region. In this case, all the sagging of the face is treated and also the ‚Äúcrow’s feet‚ÄĚ wrinkles by means of an orbicular myectomy.

Forehead wrinkles are treated by frontal muscle myectomy.
For this, a tape is removed on 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, in small procedures. When the procedure is longer, as in the case of cervical-facial lifting, anesthesia can be local together with sedation given by the anesthetist, or even general anesthesia, if the anesthetist thinks that, depending on the patient’s anxiety, it is safer.

Recovery will depend on the procedure. When myectomy is performed by direct incision, or by the eyelid, or by temporal lifting, recovery varies from one to two weeks. When the cervical-facial lifting is performed, recovery varies from two to three weeks.

The removal of these muscles leads to the long-term treatment of these wrinkles. Eventually, partial or total wrinkles may occur in this region, although this is rare. Once these muscles are removed, replacement is impossible.

There may also be mild or moderate asymmetries, which can be corrected with a touch-up, that is, a second procedure.

Depressions may occasionally occur in the areas where the muscles were removed, subject to correction with fat grafts performed in a second surgical procedure, although this occurrence is rare.

In frontal myectomy, temporary or permanent changes of sensitivity in the scalp may occur.

There is no contraindication if the patient has had previous surgery.

There is no ideal age for myectomy, just as there is no minimum age or maximum age. When wrinkles appear and are bothering you, the time is right.


Table with information
approximate


 

Anestesia

Tempo de
cirurgia

Tempo de
internação na clínica

Tempo de
recuperação

Miectomia
orbicular via incis√£o direta

local

2 hs

6 hs

7 dias

Miectomia
orbicular + p√°lpebra superior

local

2,5 hs

6 hs

7 dias

Miectomia
orbicular + p√°lpebra inferior

local

2,5 hs

6 hs

7 dias

Miectomia
orbicular + p√°lpebra superior e inferior

local

3 hs

6 hs

7 dias

Miectomia
orbicular + lifting temporal

local

2 hs

6 hs

7 dias

Miectomia
orbicular + lifting temporal + p√°lpebra superior e inferior

Local + sedação

3,5 hs

6 hs

7 dias

Miectomia
orbicular + lifting temporal + p√°lpebra superior

Local + sedação

3 hs

6 hs

7 dias

Miectomia
orbicular + lifting temporal + p√°lpebra inferior

Local + sedação

3,5 hs

6 hs

7 dias

Miectomia
orbicular + lifting cérvico-fácio-temporal

Local + sedação
ou geral

4,5 hs

24 hs

14 a 21 dias

Miectomia
orbicular + lifting cérvico-fácio-temporal + pálpebra
superior e inferior

Local + sedação
ou geral

4,5 hs

24 hs

14 a 21 dias

Miectomia
orbicular + lifting cérvico-fácio-temporal + pálpebra
superior

Local + sedação
ou geral

4 hs

24 hs

14 a 21 dias

Miectomia
orbicular + lifting cérvico-fácio-temporal + pálpebra
inferior

Local + sedação
ou geral

4 hs

24 hs

14 a 21 dias

 

 

 

 

 

Miectomia
frontal

Local

1,5 hs

6 hs

7 dias

Miectomia
frontal associada ao lifting

Local + sedação
ou geral

4 hs

24 hs

14 a 21 dias

 

 

 

 

 

 

 

 

 

 

P√°lpebra
superior

Local

1,5 hs

6 hs

5 dias

P√°lpebra
inferior

Local

2 hs

6 hs

7 dias

P√°lpebra
superior e inferior

Local

2,5 hs

6 hs

7 dias