CoolTouch, Thermage or Fraxel for Crows Feet?

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Thank you for your question. You can try a CO2 laser such as Fraxel for skin tightening around the eye area. I would recommend consulting under the supervision of a Board Certified Dermatologist or Plastic Surgeon for safest and best treatment option. I hope this helps.

The crows feet lines that extend from the corner of the eyes are usually related to squinting, or the muscular contraction of underlying muscles that make the overlying skin "crinkle" repetitively.  These type of lines, especially when only seen during muscular contraction are best treated by the muscle relaxing properties of Botox.  Even the lines at rest in this area, resultant from the same mechanism as stated above, respond well to Botox if the treatment is repeated every 3 to four months to prevent the skin from "crinkling" again. 

The sun damaged lines that some people get around the corners of the eyes might improve considerably with Fraxel restore laser done as a series of treatments. Fraxel Repair is more aggressive and takes longer to heal and is usually done once. Thermage, Ultherapy and Pelleve all have produced improvement in some patients with these lines, but not one treatment is universally effective. 

No matter how much you improve the skin tone in the area around the eyelids, once squinting and large smiles occur, the wrinkles resume.

The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Hi Lidia.  If you are absolutely against Botox or Dysport - which is the best treatment option for the crow's feet - then Fraxel would be our second choice.  For fractionated laser resurfacing, we prefer the Sciton Profractional laser for higher power, deeper penetration and larger diameter for the perforations in the skin.

Hi Lidia,

Neuromodulators like Botox, Dysport, and Xeomin are the best treatment for Crow's feet.  For our patients who want the best result for their crow's feet, we treat them with a neuromodulator  a few days before a Fraxel repair laser treatment (fractionated CO2).  We have seen improvement with our patients with Ulthera as well, it needs to be performed properly.  Good luck and be well.

Dr. P

We have all three devices, but out of all three I suggest Fraxel Re:store Dual or Fraxel Re:pair to treat crow's feet. Better results will be seen when Fraxel is used in conjunction with Botox or Dysport injections.

Botox and Fraxel laser treatments complement each other for treatment of crow's feet.  Botox relaxes the muscles while Fraxel stimulates the production of collagen in the smoothed skin. You could try just Fraxel, but the results will not be as effective.

A series of treatments with the Fraxel laser helps diminish fine lines and wrinkles around the eyes, however when you smile you will have crow's feet due to the contraction of the muscles. Another laser that is more aggressive than the fraxel is the Matrix CO2 which could also help minimize the appearance of the lines around your eyes.

Crows feet are produced with the active muscle contraction of the obicularis oculii. By relaxing with Botox this muscle doesn't contract and the crow feet are less.  If you are opposed to Botox you might want to try Belotero for your crows feet. 

Crows feet that become more apparent when you squint or smile are best treated with Botox. Fine lines and deeper wrinkles that dont move with facial expression can benefit  the most from fractional resurfacing.