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Botox for Crows Feet Cause Droopy Lower Eyelid?

I've been thinking of having Botox for my crow's feet, but my doctor told me not to do it. He would not give me the injections. He said it was not approved by the FDA for use on crow's feet because it's such a sensitive area of the face. What's more troubling is that it weakens the muscles over time and in the long run, it could result in a droopy lower eye lid! Any comments on this?

Doctor Answers (13)

Botox for Crows Feet


Hi Christie,

Botox works great for the lines around the eyes known as crows feet. Carefully injected you should have no problem and great results.

Over time, as you age, your lower lids will become lax and may even become droopy. This has nothing to do with Botox, it has all to do with aging and the effects of gravity.

If botox is injected just under the lower eyelid, occassionally it can weeken the lower lid muscle (preseptal obicularis oculi muscle) and cause temporary herniation of the lower lid fat. However, as the Botox wears off, this will resolve and not leave permanent herniation.

As far as FDA approval, Botox was used for cosmetic purposes at least 10 to 15 years before the FDA approved it for any cosmetic use. Physicians can use treatments that are not approved by the FDA which is known as "off the shelf use".

Hope this helps.


New York Facial Plastic Surgeon
5.0 out of 5 stars 217 reviews



Yes if injected incorrectly botox can cause a "droopy" eyelid, and yes botox is not FDA approved for this area, however many qualified M.D's have been injecting the crows feet including myself with perfect results.  Please make sure you are choosing a well qualified and trained physician for your botox!

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Botox for crow's feet should not cause lower eyelid droop


Done properly, Botox injections injected at specific points in the lateral eye area are safe and effective to treat crow's feet. As long as the area under the lower lid is not injected, lower eyelid droop will not occur.

Your doctor is correct that Botox Cosmetic is not FDA approved for the treatment of crow's feet. It has however been used, off-label, in successfully treating areas such as forehead furrows, crow's feet, platysmal (neck) wrinkling and to flare or arch the brows among others.

Be sure to see consult with a cosmetic surgeon experienced in the use of Botox in your areas of concern.

Anifat Balogun, MD
Seattle Facial Plastic Surgeon

BOTOX works well to soften or eliminate your crow's feet.


BOTOX injections are completely safe for reduction in the appearance of crow's feet when you smile. I have not seen change in the shape, position or tone of the lower eyelid in any of my patients.

I hope this is helpful, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 289 reviews

Botox for crow's feet


Botox works great for crow's feet.  Crow's feet develop from animation of the muscle areound the eye.  Yes, if the Botox is injected very close to the inferior orbicularis muscle, it may cause an ectropion temporarily.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Many reasons to use Botox for crows feet


Botox is actually the best treatment option for crows feet when done properly. It also can be used in the same treatment session to elevate the lateral eyebrow as was described in my publication entitled "Temporal browlift using Botulinum toxin A" Plastic and Reconstructive Surgery, 2000. It is an off label use but is very safe with a long track record.

Min S. Ahn, MD
Westborough Facial Plastic Surgeon
4.5 out of 5 stars 23 reviews

Botox Works Great For Crows Feet


Botox is used in the crows feet area as an off label use and is completely legal, ethical and effective. The risk of a droopy eyelid in the long run is less than getting it in the glabella the area betweent the eyebrows.

You need to find someone in your area who injects the crows feet regularly and you will be pleased with the results.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews



Botox is wonderful for the crow's feet and it actually helps to lift the lateral brow when done properly. We do it every day "off-label" meaning it is FDA approved for one thing (frown lines) and we use it for another problem like crows feet, downturned smile, forehead wrinkles, etc.

I would suggest you heed your doctor's advice and not them HIM do it if he is uncertain about the benefits. Go to a more experienced injector in your area and keep smiling!

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 9 reviews

Botox is the Treatment of Choice for Crow's Feet Wrinkles


Hi Christie,

Your physician is not experienced and does not know what he is talking about regarding the effects of Botox in the lateral eye area.

Botox has been used for years, and is the treatment of choice for treating crow's feet. It is used off label in this area, as it is in many other areas on the face (not FDA approved, but still proven to be very safe).

When used properly, there is no risk of either short term or long term "droopy" lower lids.

If you are getting Botox from this physician, I would question his use of it in other areas, and consider consulting with more experienced Botox injectors.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Botox is safe and effective for crows feet.



1) Your doctor is not experienced with Botox. In Manhattan, we inject Botox into the crows feet every day, without problems. It is an "off label" use, but widely accepted as safe and effective.

2) Botox can cause dropping of the lower eyelids, but only if it is done improperly. So go to an experienced plastic surgeon or dermatologist.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.