Crow’s feet wrinkles - what procedures would you suggest? (Photo)

Question

I’m 43 and my eyes look smaller, wrinkled and tired. What procedures or treatments would you suggest to make them look better? Botox doesn’t seem to last more than a month, thank you!

Nelson Lee Novick, MD · Answer

Lack of appropriately longer response to Botox (usually lasts 3-6months) can sometimes mean that too low a dose and/or too high a dilution was used. If this is not what occurred then switching to an alternative neurotoxin, such as Dysport or Xeomin, may be helpful. From the photos, the crow's feet appear quite pronounced while smiling, so I would not be surprised that at rest (not smiling) that the skin of that area would be creased. If so, then the additional use of an appropriately low viscosity, cohesive, malleable HA filler would not only improve the static wrinkles, but would supplement the neurotoxin while smiling. You would be wise to consult with an experienced, board certified cosmetic dermatologist and best of luck.

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