I recently treated a 62 years old lady for crows feet and she has returned with odema round her eyes.

Your questions answered by our surgeon, Lucian Ion, FRCS(Plast)

Asked on 18 May 2012

Question

I am an aesthetic nurse prescriber. I recently treated a 62 years old lady with azzalure for crows feet - doses within normal limits.

She has returned with odema round her eyes. I have seen this on occasions before but not to this degree. I have advised piriton as she has hay fever, cold compresses massage.

Do you think a small dose of Hylase and some massage would help?

Answer

I suspect the problem is related to weakness of the orbicuaris muscle, and this has been described with botulinum toxin treatments. The assumption is that the normal muscle function includes an element of pumping of the lymphatic flow around the lower eyelids, and when the muscle is weak some patients may display oedema. Hay fever may indeed contribute.

I doubt that hyalase would have any impact, but cold compresses may help, and I suspect sleeping with a couple of pillows to help the drainage would be beneficial . It will probably take over a month for this to settle down, as muscle strength recovery is quicker than the intervals between normal treatments.

Mr Lucian Ion FRCS(Plast)
129 Harley Street
London
W1G 6BA