Skin at the sides of your eyelids is thin, and layered over a thin sheet of muscle that wraps around the eyelids. This muscle, the “orbicularis oculi” closes the eyelids when you blink, and contracts (shortens) when you smile widely or laugh. The contracting muscle wrinkles overlying skin, causing visible creases that fan out from the outside angle of your eyelids. When you are young, these folds of skin are only present briefly when the muscle shortens. After many years of laughing and smiling however, often in the fourth or fifth decade of life, fine creases remain in the skin even when you are not laughing or smiling. These creases become even deeper over the years, and are a visible sign of aging. Each crease has a static component (its depth when your face is relaxed and you aren’t smiling) and a dynamic component (the increase in depth with smiling).
Injected neuromodulators such as Botox®Cosmetic, Dysport®, and Xeomin® relax the orbicularis muscle when treated. For the entire duration of its three month effect, the dynamic component of “crow’s feet” wrinkles is diminished or absent. Although the static component of skin lines is not smoothed immediately by neuromodulators, over time, even the static component is improved because you aren’t contracting your orbicularis and therefore aren’t deepening the lines in your skin over the treated area. Neuromodulators both smooth your existing creases, and prevent them from deepening. The anti-aging effect of these medications is dramatic if treatment is continued intermittently during adult life. Dr. Laverson has incorporated neuromodulator injections in his recommended anti-aging algorithm for years, and sees that regularly treated patients have stalled their visible aging process.
Sometimes, other methods are necessary to completely smooth skin at the sides of the eyelids such as laser skin resurfacing, injectable fillers, skin tightening, or browlift are recommended.