Aquamid Vs. Botox for Crow's Feet?

I was interested in Aquamid for crow's feet rather than Botox. Would this be a good option?

Doctor Answers 7

Botox or Aquamid for Crow's Feet

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Hi Aussie in Beautiful Melbourne,

Crow's feet are best treated with Botox. "Line" fillers should not be used in this area because of the dynamic muscles. Volume fillers such as your own fat or Sculptra may help by replacing lost volume.

Stay away from Aquamid anywhere in your body. The product has been associated with severe infections in many cases.

Good day,

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Avoid Aquamid

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Because of the nature of our practice, we see many patients from Europe. We have unfortunately already operated on several unhappy Aquamid patients. Unfortunately, the Aquamid had infiltrated into the tissues and only a partial correction was possible.

The Aquamid seems to behave much like silicone. I would personally put it in the category of the worst of the worst. Just my opinion.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Aquamid vs. Botox for Crows feet

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In general, Botox is the best treatment for the crows feet because these wrinkles are the result of underlying muscle contraction.

Fillers are not appropriate for the Crows feet because of the significant degree of movement of this area in combination with thin skin which frequently results in lumpiness. I would strongly discourage you from having Aquamid injected to your Crows feet since Aquamid is a permanent filler (not yet FDA approved in the US). Crows feet wrinkles can be significantly improved with a combination of Botox and laser or chemical peel resurfacing.

Good luck and be safe.

Bryan K. Chen, MD
San Diego Dermatologist

Aquamid and fillers

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Crows feet are best treated with Botox injections rather than longterm fillers. If you have Aquamid or other fillers in your soft tissue and have complications, these can be treated.


Dr. Karamanoukian

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Management options for crows feet

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Hello ~

I would not recommend an injectable filler for correction of crows feet as a first line treatment. A chemodenervation agent, such as Botox or Dysport would be a first line treatment.  In patients who have static rhytids or wrinkles that are present both in the presence and absence of animation, a resurfacing treatment may be beneficial in conjuction with the chemodenervation agent. Common treatments include chemical peels, such as TCA, and fractionated lasers. Consult with a Board Certified Plastic Surgeon to find out what treatment would best suit your needs. 

Best ~

Glenn Vallecillos, M.D., F.A.C.S. 

Glenn Vallecillos, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 30 reviews

Use Botox for Crow's feet!

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Aquamid is a filler for deeper tissues.

Crow's feet are primarily a problem caused by repeated muscle contraction and not by true or relative soft deficits .

Botox is the preferred and more targeted approach to managing crow's feet.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Treatment of Crow's Feet

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There is a great deal of confusion regarding the appropriate use of fillers (such as Aquamid) and Botox.

Botox is the brand name for a product naturally produced by a bacteria. The product disables the movement of facial muscles. By stopping the muscle from moving, it allows wrinkles to smooth out over time. Botox has no filling effect.

By contrast, fillers fill the space under the wrinkle making it less noticeable. The muscles will still move normally. Examples of fillers are ArteFill, Aquamid, Restylane, Perlane, Hylaform, Radiesse, Sculptra, Elevess, Evolence, Prevelle, Juvederm, Collagen, etc.

Although Botox is sometimes used in the lips and chin, it generally works best in the upper face (forehead, between the eyebrows, crow's feet, etc.).

By contrast, fillers are generally best in the lower face (nasolabial folds, lips, jowls, etc.)

Please keep in mind that Aquamid is considered a permanent filler and should be used cautiously. Currently, Aquamid is not FDA approved in the USA.

We generally recommend our patients to undergo treatment with a temporary filler to make sure they like the result.

We subsequently treat them with ArteFill which is a permanent filler currently FDA approved in the USA with a good track record and excellent results.

IMPORTANT: When selecting a qualified plastic surgeon, make sure that they are certified by "The American Board of Plastic Surgery". This is the only board recognized by "The American Board of Medical Specialties" in the field of plastic surgery.

Unfortunately, there are many unqualified individuals out there posing as plastic surgeons, who prey on uninformed consumers. Checking their credentials is the best way to protect yourself.

Good luck with your treatment.

A. Peter Salas, MD
Manhattan Plastic Surgeon

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.