Botox or Juvederm for eye wrinkles? (photos)

I am 54 and just had 24 units of Botox for glabella and outer brows. If I like the effect, I'm considering also having Botox for crow's feet. However, my wrinkles extend all the way to my under-eye area. I'm concerned that Botox, in softening the crow's feet, will make the under-eye area worse or won't have the desired effect. How many units of Botox per side? would I be better off with a peel or filler? (these are photos of a full, exaggerated smile).

Doctor Answers 20

Botox for Crow's feet

Botox for the treatment of Crow's feet is the most effective treatment for softening the appearance of these wrinkles and improving their appearance.  Botox for this area will relax the underlying muscle (orbicularis oculi) and not allow it to create harsh wrinkles during smiling. A typical dosage for full treatment of the crow's feet will range from 20-25 units of Botox. Consultation with an experienced injector would be best to determine the potential satisfaction from the treatment.

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 45 reviews

Botox and Fillers

Thank you for sharing your question and photos. Botox is the best option to treat the crow’s feet. Juvederm in this area would not accomplish the result you are looking for and would likely look unnatural.  Aside from Botox, you are an excellent candidate for laser resurfacing. In my practice, I have had excellent results using a full resurfacing laser, concentrated in the periocular region (around the eyes) to reduce the appearance of fine lines. This type of resurfacing can also tighten the skin of the eyelids and surrounding tissues. In the hands of an experienced physician, this laser can safely access the eyelid without risk of damaging the eyes. While laser resurfacing offers great long term results, I still recommend regular Botox treatments to prevent new wrinkles from developing. Best of luck!

Kian Karimi, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Botox or fillers for eye wrinkles

If you decide to go with the Botox to soften Crow’s feet, our practice usually tells clients that full treatment to that area is 10 units per each side. Botox will not be able to be placed directly under your eye to treat those wrinkles, however fillers or microneedling would be great options to help with those. Filler can be utilized to enhance/build up the cheeks and thus smooth out fine lines caused by sagging skin. As our skin ages, it usually falls downward and filler can build that area back up, smoothing out the skin. Microneedling is another great option to get rid of small lines if you prefer not to try fillers. This procedure is a great, non-invasive treatment that can decrease fine lines, wrinkles, and improve overall skin texture/tone, and brightness.

Justin Harper, MD
Columbus Physician
5.0 out of 5 stars 14 reviews

Botox vs fillers

Botox takes care of dynamic lines caused by muscle contraction by paralyzing the muscle.  Fillers work by adding volume to the deeper layers of the skin to stretch the lines. Lasers help to build the deeper tissue or abrade the wrinkles.

Botox for crow's feet

Botox is a great way to start softening the crows feet area. It is not so helpful for directly underneath the eye area. For underneath the eyes you may benefit from a combination of laser resurfacing and platelet rich plasma injections to address that area. You also have some hollowing in the tear trough area and dependent on clinical examination you may benefit having dermal filler treatment to correct this. No one treatment will give you the best results, combination is the key.

Crows Feet - Lasers, Botox, Fillers, microneedling/PRP

Crows feet and under eye bags can be treated with a combination of lasers, microneedling/PRP, botox and other fillers. Please see an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Combination treatment for periorbital (around the eye) wrinkles

I am a big proponent of combination treatment when it comes to periorbital rejuvenation. In your case, the photos demonstrate crow's feet due to contraction of the orbiculares oculi muscle. Importantly, the photos also show significant volume loss at the tear trough and along the lower aspect of the eye. Were you my patient, I would probably recommend some combination of the following:

  1. Botox injection for the treatment of dynamic wrinkles
  2. Belotero or Restylane injection for  tear trough and undereye volume loss
  3. Nonablative laser resurfacing (Fraxel) or microneedling to increase collagen production
  4. Topical skincare products including sunscreen and a retinol

Under eye wrinkles #Botox #dysport #microneedling

I believe you would benefit from the use of an endotoxin like Botox or Dysport.  You would also be a great candidate for some resurfacing options. You could discuss heavier laser resurfacing or possibly something in office like microneedling.

Jack Peterson, MD
Topeka Plastic Surgeon
4.4 out of 5 stars 34 reviews

Botox and Halo...

You can definitely benefit from Botox to your crowfeet but I would also like to recommend a laser resurfacing as well.  Consider Sciton's Halo.  This is help strengthen and tighten your skin, address any fine lines and wrinkles, and correct any discolorations your skin my have.  Hope this helps.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 121 reviews

Botox for crows feet

Botox would give you the most immediate effect.  If you would like to add filler at a later time you certainly can do so.  Under the eyes I highly suggest have the "cannula technique" performed as opposed to the standard needle technique.  It produces less or no bruising, even results and is very "ouchless."

Gregory Pistone, MD
Cherry Hill Dermatologist
5.0 out of 5 stars 5 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.