Botox Around Eyes For Crows Feet?

I am interested in having botox around the eye area for crows feet but have been told I have an absent Bell's phenomenon. Is there any risk of corneal ulceration by having these injections?

Doctor Answers 12

15% of population do not show a Bell's phenomenon

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For the crow's feet, it is my opinion that a small amount of Botox is not going to change function of your eyelids. However, if you have had problems with your eyes, I would not recommend Botox for crow's feet. Find an oculoplastic surgeon who does cosmetic work and they can help you wrk through the thought process regarding what to do.

Botox for Crows' Feet

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Botox is ideal for the crows' feet area.  In fact, that is how the cosmetic properties of Botox were first discovered.  The absence of Bell's phenomenon should not be an issue in this area- just don't have Botox injected in the eyelid just below the eye.  That often results in weakening the "sling" of the lower eyelid, and then the lid will pull away from the eye itself, causing a dry eye (temporary if it happens).

Christopher R. Hove, MD
Paoli Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Botox for around the eyes

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Botox is a very safe and effective treatment for the upper face in particular, and  has been used extensively and for many years for Crow's feet with rarely any problems. There should be no problem with your case either. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

The Nonsurgical 3D Vectoring Crow's Feet Lift

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Botox, and other neuromodulators that relax muscle movement, such as Dysport and Xeomin, are excellent ways of diminishing crow's feet wrinkles, particularly dynamic lines (i.e. those worsened by smiling), but also to some degree static lines (those present at rest).

In cases where wrinkles at rest predominate or in instances when there are neurological contraindications to the use of Botox, The Nonsurgical 3D Vectoring Crow's Feet Lift is an excellent method for improving this region.

Once again, 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 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 (neocollagenesis) occurs in response to the presence of the injected material. If deemed necessary, and if no contraindications exist, microdroplets of Botox (or any of the other neuromodulators) may be added to to the region in the usual manner to further enhance and prolong the overall aesthetic effect.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Botox and eye treatment

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Botox will certainly help soften crow's feet and lines and wrinkles around the eyes. Be sure to consult and have treatment by a well-trained and informed provider for best results!

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Botox for Crow's Feet

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Botox is one of the best things around for eliminating fine lines and wrinkles such as the ones you have in the crow’s feet area. Rather than "plumping" like collagen and fat, Botox blocks the impulses that nerves send to muscles, essentially paralyzing the muscles and diminishing their ability to tense. Using a very fine needle, the surgeon injects Botox in small doses where the facial muscles are most active--between the eyebrow and at the sides of the eyes, or beside the mouth. After receiving treatment, you're forbidden to lie down for several hours, because the medicine can absorb unevenly. It takes one to three days to see the effects, and the treated area will continue to improve for up to two weeks. That's when I schedule my patients to return, to see if a touch-up is needed.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Botox for crow's feet

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If injected by an experienced board certified plastic surgeon or dermatologist it should not be a problem.

Good luck

Minimal risks treating the crow's feet with Botox

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Botox or disport injections have become the treatment of choice for the treatment of crow's feet. This is performed by injecting into the muscle that surrounds the eye. The biggest risk in this area is bruising. Checking for the presence of a Bell's phenomenon is not usually part of the pre-treatment evaluation and I do not  consider this a contraindication for injection.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Botox for Crow's Feet

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 Bell's phenomenon is how the body protects the eye during sleep or when the eye is closed. Without a Bell's, the thing that protects the eye is how well the lids close. This is controlled by a small portion of the orbicularis muscle (the muscle that closes the eye) at the medial side of the eye. The nerve that controls this comes up from below. Therefore, Botox to the lateral part of the orbicularis should not effect eyelid closure.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Botox and Bell's phenomenon

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Most people exhibit Bell's phenomenon i.e. the eyes roll upward when the lids close. Lack of Bell's phenomenon does not preclude Botox injection for crows' feet as the lids will still close and blink normally. It may be more of a problem if the eyelids themselves are treated with Botox for blepharospasm for instance.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 42 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.