Is fat or Botox better for crow's feet? Can I inject fat over Botox on crow's feet?

Neurotoxins work on "dynamic' wrinkles.... so, if you have wrinkles when you squint then botox id the best choice. For wrinkles at "rest", fillers and fat and resurfacing become the better choice.

The most effective treatment for the crows feet lines are Botox or Dysport which will soften the lines by decreasing the muscle contraction in this area. Fat transfer is useful for replacing volume typically placed in the deeper planes of the face. The crows feet area is much more superficial and would not be an ideal location for fat transfer. Small amounts of a thin filler in combination with Botox can be used to fill in the static wrinkles in the crows feet area. Resurfacing laser treatments can be helpful to build collagen and smooth the lines in this area. Daily sunscreen, skin care products, and sunglasses are also beneficial to maintain results of treatment. Please consult a board certified dermatologist or plastic surgeon experienced in aesthetic treatments. Best wishes. 

It really depends on your overall goal. Neurotoxins work well for fine lines but are temporary. Fat injections as usually reserved for more deeper lines and do need repeated injections to provide a more lasting improvement. You may also want to consider treating the skin directly with a laser skin treatment or radio frequency technology such as InMode Fractora. They may be able to provide you with more lasting results than neurotoxins or fillers. 

Botox to stop the dynamic lines that occur from smiling (crow's ft) are probably the best recommendation.  I would not recommend fat in that area.   If the lines at rest are bothering you - then using a thin filler such restylane could help.   But please note that fillers or fat do not stop the motion that's causing the wrinkles in the first place.  That's why botox is probably the better option.

Hi Candy, fat transfer for an area like the sides of the eyes would be difficult.  Fat transfer generally works best in areas where a healthy fatty layer exists to begin with and this is not the case in the crow's feet area.  Your best bet would be to stick with Botox, Dysport or Xeomin.  Good luck. 

Dear candytang1121,Botox is generally an on off switch for muscle activity and a great choice for crow's feet. I get a fair amount of actors/actresses in my practice that are looking to reduce wrinkles but keep some expression. Finding an experienced physician injector is your best bet. Most of patients see first changes after 4-7 days and the final results after 10-14 days.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Yes, Botox would be a great option to improve Crow's feet. Botox results last 3-4 months. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Hello,Thank you for your question. As others have mentioned, the cause of "crow's feet" is from muscular contraction of the orbicularis oculi muscles. Since the muscle is superficial and the skin is relatively thin, the wrinkles tend to be noticeable, especially if you have improved the appearance of the surrounding tissue. Botox or Dysport treatment are ideal for that area to weaken/prevent muscle contraction in the area to soften or efface the wrinkles. Adding volume (fat) may result in noticeable puffiness or lumpiness due to the thin skin in the area without improving the wrinkles when smiling because the muscle activity will still be intact.Hope this helps!

In my opinion, Botox would be better to treat crow's feet that fat transfer.  Crow's feet are caused by muscular action of the muscle on the sides of the eyes and Botox will directly relax this muscle and improve the lines.  Because the skin there is so thin, adding volume with fat could just make the area fuller without improving the lines.  

Technically speaking, fat transfer is to fill a deficit or loss of volume, while Botox is a neuromodulator which decreases muscular contractions (the cause of a wrinkle). Additionally, Botox lasts 3-4 months. Most of our patients receive 9-12 units of Botox per eye for crow's feet, and are injected every 4 months, on average. This is preventive in nature, by not allowing the lines in this area to ever get too deep, because the muscle is intentionally weakened.Regardless, if you get Botox now, yes you could theoretically have fat injected again in 3 months. By that time, the Botox will be wearing off anyway, though, so keep that in mind.Hope this helps!