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Crows feet are best treated by Botox, Dysport or Xeomin as they relax the muscles and it is the muscle contraction that makes the skin fold on itself. Fillers can look lumpy at rest if thick, and Radiesse is a thick filler so avoid it in this region! Radiesse is meant to be injected more deeply in the subcutaneous compartment and the skin and subQ of the perioribtal area is very thin. If any filler is used, Restylane might be but here too, it may cause some lumps and even a bluish color. Some doctors may dilute it for this area with anesthetic, off-label. There may be a thinner product of Restylane coming to market eventually and this would be better for tis area.
Cows feet are dynamic lines and best treated with a neuro-toxin such and Dysport or Botox. A study just out, shows Dysport has better results on the Crows feet than Botox. Radiesse should be avoided under the eyes , crows feet, and lips, as the dynamic action of the obicularis muscle can lead to nodularity. Hyaluronic acid is much better in these areas.
My first line of defense for crow's feet is Botox. Sometimes we will go back and use a filler in this area if it is warrented. Typically we would use a HA based filler, (Restylane or Juvederm). Radiesse is usually reserved for injection into deeper layers of the skin.
Crow’s feet lines and wrinkles are primarily caused by contraction of the orbicularis oculi muscle, but the amount of skin damage and laxity plays a role as well. The best treatment, therefore, should be aimed at treating the cause of these lines. Botox and Dysport relax the orbicularis muscle and reduce its contraction, thereby reducing the wrinkling of the overlying skin. Prolonged reduction of muscle contractions will therefore reduce the number of visible wrinkles in the overlying skin, and the crow’s feet will improve. Soft tissue fillers may be used to fill lines and wrinkles. However, in the crow’s feet area, they do nothing to reduce the underlying muscle contraction and therefore the major cause of these lines and wrinkles remains untreated. Fillers may provide an improved appearance at rest, but once the orbicularis muscle contracts all those crow’s feet lines will be immediately visible. In contrast, Botox and Dysport will reduce both dynamic and resting crow’s feet lines. Radiesse is composed of calcium-phosphate microspheres suspended in a gel. It is white in color and has a pastier consistency than the hyaluronic acid gel fillers. Radiesse is generally meant to be used in the subdermal plane or deeper in the subcutaneous tissues. If used superficially within the skin, or beneath very thin skin (like the eyelids and periorbital region), Radiesse may be visible and/or appear irregular or lumpy. Radiesse is very good for midface volume restoration and contouring, where it is placed deeply in the subcutaneous tissues and over the bone. Botox or Dysport should be the primary treatment for crow’s feet lines and wrinkles. If soft tissue fillers are to be used in the lower eyelid and crow’s feet then Juvederm and Restylane would be better options. Meticulous placement is performed with a very fine needle, and should be done by an experienced injector.
It is not recommended to use Radiesse to smooth the lines around the eyes, known as crows feet. The lines are too superficial and by using a filler, it would make it too lumpy. Using Botox would improve the crows feet and give you better results. I would make an appointment with your plastic surgeon to show him what you are trying to improve.
