Question:
I read the paragraph below on an Oprah.com article, and was wondering if this muscle is commonly or ever frozen by botox injections? “When someone smiles out of genuine delight, a facial muscle called the orbicularis oculi involuntarily contracts, crinkling the skin around the eyes. Most of us are incapable of deliberately moving this muscle, which means that when a person fakes a smile, her orbicularis oculi likely won’t budge.”

Dr. A’s Answer:
I have not looked at Oprah’s explanation, but it is not true that the orbicularis muscle is inactive during a fake smile. It is very easy to voluntarily activate that muscle and a fake smile would most certainly include the orbicularis. In fact, it would require a great deal of concentration to fake a smile and not use the orbicularis muscle to any appreciable degree. It is true that a faked smile is different than a real smile, but it has to do with the fine details of the activation and includes all of your smile muscles, not just the orbicularis.

Botox could be used to fully disable the orbicularis muscle. But this is never done. You only treat the portion in the Crow’s foot area. If you were to disable the entire muscle, you would not be able to close your eyes except by passive “spring” of the tissues and gravity. This is seen in people after nerve injuries or strokes and it can be very dangerous to the health of your eye.