Why Have Botox Injections Not Significantly Reduced my Crow's Feet? (photo)

A couple of issues going on in the lower lateral crows feet area.  This is where the orbicularis oculi muscle around the eye overlaps the top portion of the zygomaticus muscle which is the predominant muscle for smiling.  Those lower lines lie right on top of this junction.  The orbicularis muscle can be relaxed easily with superificial placement of Botox.  It appears there still is activity to this muscle.  It would appear that either the product was injected too deeply thus not affecting the orbicularis which lies just below the skin surface.  I generally don't like to go after the top of the zygomaticus muscle as this can not only impact your ability to smile but can really start giving your face that flat, stroke like appearance. 

It's not uncommon for the crow's feet/lines to return sooner than you might expect. Occasionally, not waiting the recommended time between treatments can result in some resistance. The skin itself gets more lax with aging, and there are other treatment/options for skin tightening, along with Botox.

For most cases of crow's feet related to movement, the use of neuromodulators, such as Botox, Dysport and Xeomin are effective. I have found that a more effective and inclusive approach involves the use of both neuromodulators and treatment directed to the static wrinkles that inevitably result from years of continued folding of the skin with facial movement. For this purpose I have found The Nonsurgical 3D Vectoring Facelift to be especially useful when combined with neuromodulator treatment.

Using the principles of vectoring with volumizing fillers (see The Nonsurgical 3D Vectoring Facelift, The 3D Vectoring Necklift, and the The 3D Vectoring Browlift for further explanation), the region over the bone within the fixed (nonmobile) area of the cheek directly in front of the ear is used as an access point to instill "strands," "strains," or threadlike amounts of the volumizer in a fan shape distribution over the mobile crow's feet (periorbital) area and extending onto the cheek. Requiring only a tiny amount of local anesthesia to numb the entry points, the procedure is relatively painless and takes only a few minutes on each side to perform.

As a rule, immediate smoothing of the crow's feet area is seen. However, as with the other Nonsurgical 3D Vectoring Lifts, continued improvement is anticipated over the next six to eight weeks as new collagen. Treating both the motion and static components of the problem tends to prolong the results of therapy beyond that which might be obtained with either therapy alone.