Botox Touch Up Crows Feet: One Prick Enough?

I was happy with my last botox results: a smooth forehead, nose, chin and no more crow's feet. And it looked natural, 'soft' and didn't feel weird. However, after 1 month the crows feet and bunny lines were coming back slightly. I was dissapointed, I hoped to stay wrinklefree 3 months. Today I got some additonal botox in these areas. My question is about the crows feet: the doctor only did one one prick there on each side. Is this common? Because he did about 3 on the first round.

Doctor Answers 11

Botox touch up

Thank you for your question.

Length of effect from Botox is often dose dependent and for how long patient has been using treatment:long term users learn to avoid using the muscles targeted by Botox -hence wrinkles do not crease skin so quickly. Higher doses of Botox switch off more nerve endings to a muscle due to higher rate of diffusion of the medicine. But if a patient wants to avoid frozen unnatural look then smaller doses are used, these, however, might not give lasting effects.

 Touch up injections often done 2 weeks after the procedure and smaller doses and fewer injections are used.

London Dermatologist
4.7 out of 5 stars 29 reviews


It is hard to answer your question without any pictures.  3 injections in the crows feet area is normal.  When touch-ups are required, as in your case, a physician will assess where Botox is needed and how much.  It is a subjective assessment.  


You should wait 2 weeks after your last treatment to assess whether the single injection has worked.  If your wrinkles are still present, you may need more.  Be sure you are seeing a board certified physician with significant experience with Botox.  If your results repeatedly wear off after less than 3 months, make sure that they are storing and diluting their Botox appropriately.

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Botox for crow's feet

Typically you see Botox wearing off first, around the eyes. If your provider injected one spot laterally to your eyes, it depends on how much product was done but it can diffuse nicely.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Crow's feet and Botox

Typically 3-4 needle sticks will distribute enough Botox to cover the outer rim of the orbit to 'freeze' the crow's feet. Perhaps you did not get enough Botox to get all of the muscle blocked to treat your crow's feet. You need more. Go back and get some more injections.

Hratch Karamanoukian, MD, FACS
Buffalo General Surgeon
4.8 out of 5 stars 41 reviews

Injection technique around the eyes

When injecting the crow's feet, I like to imaging a C-shaped distribution for the Botox in that area.  It may take 3 or 4 little injections to put the Botox exactly where I want it, sometimes more if the crow's feet extend more widely.  Really the key is the delivery of the Botox to exactly the area you want to treat - the number of needle sticks is of lesser importance.
Hope that helps!

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

Botox for touch-up for crow's feet

Every injector has his/her own technique.  Wait for your results and if you are not happy, visit your doctor again for re-assessment.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

BOTOX in outer eyelids

Botoulium toxin is a wonderful means of reducing crow's feet. Each injector differs in his/her technique. In the end what matters is the number of units injected and the precise injection sites. Typically 7.5 to 10 units are injected in the outer eyelids. With fillers being placed in the lids, less and less botox is being placed in the lower outer eyelid.

Rand Rodgers, MD
New York Oculoplastic Surgeon

Botox for Crows feet - touch up

The Botox you had may not have lasted as long as you had hoped based on the injector experience, technique, and dosing. Make sure you visit with an experienced & highly trained cosmetic physician such as a dermatologist or plastic surgeon for optimal results and safety. Generally speaking, three injection points are used around each eye; perhaps only one poke was made in the middle (as there is some diffusion) as perhaps that was the area that was most noticeable - you may just want to ask the Doctor why they chose to do that. Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.9 out of 5 stars 49 reviews

Botox touch up

On touch ups, the same amount of injections are not performed as when the initial injection treatment.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 27 reviews

Botox touch up? One prick

When I do Botox for crow's feet I commonly do at least three sticks. However, if you were getting a touch up you might not have needed your Botox spread so much. Also, if the doctor used Dysport there would be a little more spread on its own. Massage probably also helps spread in that area. Do not get concerned until you see how it does. You might be pleasantly surprised

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 18 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.