26 with crows feet - when to begin addressing this? (Photo)

Question

I am turning 26 in a couple months and over the past year have noticed that I have significant crows feet around my eyes when I smile now. I haven't gained any weight in the past year. I am very low maintenance when it comes to procedures and intervening on my skin. When should I start addressing this? I've heard botox can be used preventively so I am wondering if it would benefit me right now and if so how many units roughly is a normal starting amount?

Jason Emer, MD · Answer

I often recommend my younger patients start early with anti-aging treatments. A combination approach will give the most improvement. Botox and/or fillers, lasers, and microneedling/PRP can improve crow's feet and under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Bhupesh Vasisht, MD · Answer

Hello! Thank you for your question. The best option for wrinkles at the corners of the eyes (crow's feet) is to use a neuromodulator, such as Botox or Dysport. These treatments temporarily weaken the small muscles in this area which cause these wrinkles while smiling or squinting. Botox is the preference for most physicians to treat crow's feet. No worries, it is not uncommon for patients in their 20s to seek botox treatments for this very reason. Hope this helps.

Michael P. Morrissette, DDS, FACS · Answer

Neurotoxins like Botox work on dynamic wrinkles.... wrinkles in motion with muscle activity. Static wrinkles are not eliminated with the use of Botox. A simple non-surgical treatment for your case is the use of Botox, Xeomon or Dysport.

Kristin M. Baird, MD · Answer

If you are bothered by your crows feet lines you would benefit from Botox, even at your young age. Botox can soften these lines and still give you a natural expression if done properly. You will likely need fewer units since you are younger and only have lines on movement. Your skin should look more youthful as you age as long as you're performing good skin care, especially sun protection. Please consult an experienced dermatologist or plastic surgeon to give you a refreshed look not a frozen, overdone look. Best wishes.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question. You can start using Botox now. If the injections are performed correctly, it should make your eyes look nicer and help to delay the progression of your wrinkles. Make sure a highly experienced doctor evaluates and treats you.Good luck,

Kenneth D. Steinsapir, MD · Answer

The idea of using Botox preventively makes sense but there is no evidence to support it.  I say use it now to make yourself look great.  Don't let doctors freeze your forehead.  Study my patented Microdroplet Lift method that softens the resting brow pinch, reduced forehead and crows feet lines without freezing the forehead.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. The best candidates for the non-surgical Botox treatment includes physically healthy people who are realistic in their expectations and desire to improve the appearance of facial lines and wrinkles. Botox can specifically address crow's feet. I suggest that you move forward and consult with a board certified facial plastic surgeon.
Best wishes,

Michelle Copeland, MD, DMD · Answer

It is quite common for me to see patients your age in my office.  Botox is one of the best things around for eliminating fine lines and wrinkles such as the ones you have. Rather than "plumping" like collagen and fat, Botox blocks the impulses that nerves send to muscles, essentially paralyzing the muscles and diminishing their ability to tense. Using a very fine needle, the surgeon injects Botox in small doses where the facial muscles are most active--between the eyebrow and at the sides of the eyes, or beside the mouth. After receiving treatment, you're forbidden to lie down for several hours, because the medicine can absorb unevenly. It takes one to three days to see the effects, and the treated area will continue to improve for up to two weeks. That's when I schedule my patients to return, to see if a touch-up is needed.

Kristine Romine, MD · Answer

Thank you for your question. You are so wise to start thinking of your skin health at a young age. In my practice, those in their 20s come and see me when they start to notice fine lines and wrinkles at rest. Neuromodulators (muscle relaxers) like Botox, Dysport and Xeomin help to reduce these fine lines and wrinkles. It has been my experience that, in order to keep results consistent, patients will need treatments every three to four months. The number of units required is patient and dose dependent so I’m unable to give a definitive answer about the number of units you will require. Typically the younger you start the fewer units you will require ranging from 6 -12 Botox units per side. While treatment with neuromodulators can help, it is also important to consistently apply sunscreen throughout the day to all sun exposed skin as the sun plays a large role in the development of these fine lines and wrinkles. It is best to seek out a board certified dermatologist or plastic surgeon who has extensive experience and training in this field as results are also dependent on the artistry of the injector.

Jennifer Trent, MD, FAAD · Answer

Now is a good time to start Botox treatments.  This can help prevent your dynamic lines (the lines that occur when you smile) from becoming permanently etched in your skin.  Static lines, or the lines you have at rest, are harder to treat.  Always seek treatment from a qualified physician.

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