What options do I have for intense smile wrinkles? (photos)

This is what happens when I smile. What should I do?

Doctor Answers 7

Smile wrinkles (crow's feet) around the eyes

Wrinkles around the eyes and on the forehead can be minimized using Botox injections, which restrict movement of the muscles that cause the wrinkles.  Lasering and dermabrasion, as well as fillers such as Restylane Silk, can be used to improve the appearance of deep lines.


Rochester Facial Plastic Surgeon
4.5 out of 5 stars 22 reviews

Smile Lines and Crows Feet

Hi and thank you for your question!

This is a typical area for people to notice the most bothersome of lines and wrinkles due to the thin and fragile skin of the eye area. Botox or Dysport would help to soften these, while maintaining a natural look. Also be sure to wear sunscreen daily and reapply every 1.5 hours while outdoors. UV exposure really breaks down the collagen and elastin in the skin. Keep your UV protective sunglasses on, as well. Long term, you may want to think about a skin resurfacing laser to repair the tissue more permanently, since the Botox or Dysport is temporary.

Best,

Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.8 out of 5 stars 137 reviews

Crow's Feet - Eye Wrinkles

Thanks for inquiring. Frown lines, crow’s feet, and forehead furrows are all unfortunately signs of aging and a lot of muscle activity. In your case a lot of smiling! From the picture you provided i see that you would benefit from Botox or Dysport for both your forehead lines as well as crow's feet wrinkles.
Botox and Dysport are great treatments to temporarily improve the appearance of both moderate to severe frown lines between the brows and crow’s feet. Results typically last 3 - 4 months. Hope to hear from you soon!

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Crow's feet treatment

This area along the sides of your eyes is an ideal place for a Botox/Xeomin/Dysport treatment.  (Note: Botox, Xeomin, and Dysport are similar products made by different companies).

The treatment is performed by injecting small amount of product into the muscles around your eyes.  Those muscles tug and pull on your skin when you smile, creating wrinkles.  A Botox treatment works by weakening those muscles, which reduces the tugging and pulling on the skin.  This effect helps smooth out the area and prevent wrinkles from forming.

The treatments work very well if done consistently (repeated every 3-4 months on average).  They can look very natural in both men and women when injected correctly by a well-trained doctor. 

Best of luck.

Kyle T. Yamamoto, MD
Reno Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Botox, Xeomin or Dysport may be considered for reducing the appearance of dynamic crows feet.

Consider consulting with a reputable physician experienced with Botox, Xeomin or Dysport so you could see if this would be right for you.

Hope this helps.

Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 396 reviews

Botox For Smile Lines

Thank you for your question and for sharing your photograph.  Sorry that you are having some concerns about your smile lines.  Botox works well to soften smile lines around the eyes and on the forehead.  Botox treatment will soften the contractile ability of the underlying muscle and, as a result, improve the appearance of the overlying skin creases.  Please keep in mind that Botox will start working a couple of days after injection and the final result will be seen at 2 weeks.  Botox typically lasts for 3-6 months.  Etched creases may require multiple Botox treatments to see the best result.  Please be sure to see an experienced injector for an in-person consultation to fully address your concerns and discuss your goals and expectations in order to determine the best course of action.  Best wishes! 

Wrinkles Peri-Orbital

Hello thanks for your question. This appearance is typically called "crow's feet"- medical term peri-orbital rhytids. The most common treatment employed is botulinum toxin every 3 to 4 months (Botox, Dysport or Xeomin are the three brands available). You may also want to consider a series of smoothing treatments with Ultherapy- this device uses microfocused ultrasound to stimulate new collagen formation which results in smoother skin. Other options include laser skin resurfacing. Avoid excessive sun exposure as this accelerates your collagen loss.
Best of luck
Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 10 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.