Uneven crows feet Botox. Will this even out or do I need a top up? (photos)

I always recommend waiting a full ten days before making any decisions about touch-ups.  The Botox can take that long to come into full effect and the results might be changing.  I would advise speaking with your injector with any questions or concerns you might have.All the best,

I would recommend waiting at least 2 weeks after the Botox treatment to your crow's feet before having a better idea of your final results.  If you still feel there is some unevenness after this time, I would contact the physician who treated you since a touch up treatment could be helpful.  

It can take up to two weeks to see your final result from your Botox treatment. If after that time you still have concerns, return to your injector for an evaluation. Botox treatment results typically last about three to four months and fade gradually.

It is too early to see the full effect of your botox injection. Wait another 10 days more and get re-evaluated by your provider.

It may take up to 2 weeks to see the full results of your Botox treatment. It's too early to judge your results. Give the Botox a little more time to work. 

Hi, thank you for your question. Botox typically takes up to two weeks to show full effect. Sometimes, it's also the time it takes before the results are symmetric as one side can react a little bit faster than the other. I would recommend you wait a full two weeks before deciding if you need a touch up. If, after two weeks, you are still not satisfied with what you see, it is a good time to schedule a follow-up appointment with your injector as the results won't keep improving at that point. I hope that helps. Best of luck!

Onset of action of neuromodulators (i.e. Botox, Dysport, Xeomin) varies a good deal from person to person.  I re-evaluate my patients after two weeks to make sure they are fully satisfied with the cosmetic results of their treatment.  As long as you aren't having any adverse side effects, I wouldn't make any conclusions about your result until that time.  Then, of course, if there is still asymmetry, it would be reasonable to discuss a "top-off" with your treating physician.
As a general rule, you will have the best results for Botox or other neuromodulator injections with a skilled injector who is board-certified in one of the core aesthetic specialties (i.e. dermatology, plastic surgery, facial plastic surgery).  

Thank you for your question and for sharing your photographs Alannax. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment in the absence of consistent photographs before and after in the same lighting and angles for comparison. However, I hope the information provided here is useful.The pivotal studies used 24 units of Botox (12 units per side) to address the crow’s feet. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary. 
If I had a patient with the concern described here I would recommend being patient and waiting a full two weeks before assessing the results. Sometimes it takes longer for Botox to take effect in one area as compared to another area.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

Thank you for your question.Botox and other neuromodulators can take up to 2 weeks to be effective.  I have personally found that the crows feet area can take a little longer than the forehead or glabella to be noticeably effective.  Please give it a little more time and of course if not symmetric in 2 weeks reach out for a touch up.  It may be that just not enough was injected.  Crows feet can take a relatively large amount to see good effects compared to say the forehead.Best Dr. L

Hopefully your injector has advised you that the results from Botox can take up to 14 days. After 2 weeks if you are still not seeing results, i would recommend that you speak with your provider and be evaluated to determine if you need additional units.Best wishes,Pamela Stuart, MD