Botox on Crows Feet Didnt Work. Done Again but Didnt Work Again. Should I Allow the Dr. to Inject More?

Question

Botox on Crows Feet Didnt Work.  Done Again but Didnt Work Again.  Should I Allow the Dr. to Put More in

Ron Shelton, MD · Answer

Did you have enough units of botox? Were the injection sites appropriate for your anatomy? Did you define crows feet as the lines that extend underneath the lower eyelid or keeping them as the lines to the side of the eyes?

	These are important questions to be answered when resolving your issue. See an expert Botox injector in person.

Robert Strimling, MD · Answer

After two treatments as you have described, I am not sure that more Botox will be helpful. I would consider additional complimentary therapy, llike Exilis radio-frequency treatments, which we find helpful for wrinkles around the eyes. 4-6 treatments are recommended.

James Bartels, MD · Answer

There are several possible reasons why Botox didn't work on your crow's feet. It could be due to technical error if your injector was inexperienced, insufficient dosing, or lines that are too deep to be completely erased with Botox alone. It could also be that your expectations are too high. Even after successful Botox treatment, it is common to still get "crinkling" around the eyes when you smile.

	Rather than having more Botox injected now, consider another opinion from an experienced facial plastic surgeon, dermatologist or oculoplastic specialist. Good luck!

Peterson Pierre, MD · Answer

Botox works beautifully in this area. This may be an issue with the injector or with the amount of Botox that was injected. Always see an expert injector, either a board-certified dermatologist or plastic surgeon for all your cosmetic treatments. Find out how many units were injected at each visit and, if your injector doesn't meet the criteria listed above, consider seeing someone else.

John Farella, MD, FACS · Answer

Thank you for your question. Approximately 1 to 3% of patients that are injected with Botox have antibodies to the product. Some patients give a history of having food poisoning in the past which was severe. If you are a patient that has antibodies against Botox then any area of the face that is injected will not work. Since  you have been injected twice with no response you are likely to be in the 1 to 3% of patients who have antibodies. You may want to try a different physician . Only inject one area on the face to see if you respond. If the treatment again does not work , I would consider you a patient who has antibodies against Botox. After the third try with no response, I would not waste anymore time or money on Botox injections. You may want to consider the use of Dysport. However there are no guarantees that Dysport will work. I hope this was helpful. Good luck

	                                                                                             John F. Farella M.D.

Renita (Lourdhurajan) Rajan, MD, DNB · Answer

BOTOX injected for the crow's feet is one of the most rewarding botox indications. Typically, between 8 -12 units would be used per side. I would suggest considering a different injector, before considering a larger dose, in case you were given anything in the above range.

	Good luck!

Francis R. Palmer, III, MD (retired) · Answer

There are only three reasons that two Botox treatments didn't reduce your Crow's Feet IMHO.

	
		Inexperience of injector or low dose of Botox injected.
	
		Poor placement of the Botox (wrong area).
	
		The cause of the Crow's Feet are very low eyebrows that have in essence created lines due to accumulation of excess tissues which Botox will not raise...this would require a Brow Lift.

Lee Robinson, MD (retired) · Answer

It is unlikely that after two treatments that more Botox would give the desired result. Botox works by weakening the muscles that cause "dynamic" wrinkles or those that occur when we move the face. Over time with increased laxity of the skin and continued expression, these wrinkles become "static" and remain when the face is in repose. Botox may soften these lines but it is unlikely that it will completely eliminate them, especially if the skin in the area has become what we call "redundant" or too lax.

Botox on Crows Feet Didnt Work. Done Again but Didnt Work Again. Should I Allow the Dr. to Inject More?

Answers (8)

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