Botox is not helping to minimize the appearance of crows feet - is this common with aging?

Question

Botox is not eliminating my crows feet, although it used to. I get around 32 units of Botox for forehead, 11's and crows feet. My injector advises that only filler will help eliminate the crows feet. Is this common with aging?

Nima Shemirani, MD · Answer

Hi @Zazena! I would recommend adding additional units of botox to help reduce the amount of wrinkles in the crows feet area! Typically, I recommend 12 units on each side of the crows feet.

Jonathan Kulbersh, MD · Answer

Thank you for your question. Botox is an ideal treatment for crow's feet and 11 lines when properly administered and the appropriate dosage is determined. These injections may also be combined with dermal fillers, microneedling, or laser resurfacing treatments to enhance the results and further reduce the appearance of fine lines and wrinkles. I recommend scheduling an in-person consultation with an experienced expert injector. They will be able to review your injection history, discuss your concerns with you, and help you decide on the best course of action.

Jason Emer, MD · Answer

Botox can be used to improve wrinkles around the eye. Deeper wrinkles need a combination approach with Botox and lasers, microneedling/prp and fillers. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Zoran Potparic, MD · Answer

At some point, due to skin aging, crows feet lines are deep and can not be improved with Botox. Excision by means of surgery (blepharoplasty) or injection of filler; we use nano fat grafts in addition to surgery, when needed. Hope this helps.

Caner Kacmaz, MD · Answer

Botox works great for crow’s feet, and it can make a dramatic impact even when you have deep lines. After the treatment, the skin underneath and around your eyes look smoother. The FDA recommendation for treatment of the crow's feet is 12 units per side, but this can vary from patient to patient. 
However, in some cases Botox injections do not work for some patients, such as the ones with very deep wrinkles. Depending on the cause of your crow's feet, we may recommend a filler rather than Botox. A filler contains a substance such as hyaluronic acid that fills in the spaces under the skin. For the best results, fillers can be used along with Botox. Best wishes.

Rene Garcia, MD · Answer

We have 2 types of wrinkles. Dynamic and Static wrinkles. Botox works well in dynamic wrinkles. Those that shows with emotions or expressions. For deeper wrinkles results are not effective. What type of wrinkles do you have?

Oakville Plastic Surgery &amp; Medspa · Answer

Yes filler can help your crows feet, especially lines that extend further than average . However, before you move into a new solution, you may consider increasing the dose of Botox you are having injected in your crows feet. I have some clients who do require a more generous dose to have the same positive effect as other clients.

Camille Cash, MD · Answer

Botox will be effective at softening the appearance of crow's feet that are related to muscle movement.  If there is skin laxity that is contributing to the overall area, that will not be improved with Botox.  In those cases you may have better results with a combination of treatments such as Botox, fillers, and Morpheus8.  See an expert injector near you to learn more.

Rita Rakus, MBBS - Account Suspended · Answer

Hello and thank you for your question. A face to face consult and examination is always best however in this scenario yes it's possible that with age botox can be less effective. This is because although it still may be relaxing the muscle underneath the skin overlying becomes more lax with age.  Please always seek treatment from a trained medical professional for any cosmetic treatment. Best wishes

Robert T. Buchanan, MD (retired) · Answer

Botox is just one modality in improving your appearance. It reduces the formation of wrinkles caused by muscle action. Once you have static wrinkles, all it does is help prevent others, but will do nothing for those already there. In addition to Botox, you need to be using tretinoin and Obagi’s ELASTIderm regularly with your skin care to stimulate collagen and elastic tissue. Once on these, you can add micro needling or Fraxal laser to further stimulate collagen . You can also inject the wrinkles with a filler to reduce them, as has been suggested, but should only do these last options if you are on the tretinoin and ELASTIderm.