Will getting Botox on the outer corner of the eye that wrinkles when smiling, change the look of your expression when smiling?

I'm afraid I will look less happy or not have the same expression if I get Botox on the outer corners of the eyes but the wrinkles do bug me. Any advice?

Doctor Answers 13

The "joyless" smile - aka the "Botox smile" or the "Pan-Am" smile

Great question texaswildflower - in fact a bit of philosophy goes into it - you do seem to think quite deeply.

On the surface it may seem the right thing to do to remove those smile lines that pop up at the corners of our eyes when we smile, especially since drug companies decided to call them by the ugly term "crow's feet" - I call them smilies.
But is it really the right thing in terms of facial expression as a whole?
Probably not. A term in popular psychology is the "Pan Am Smile" named after the friendly but forced smile that was trained into the Pan Am flight crews when greeting people as part of their "great customer service" image.
Today, some may refer to it as the courtesy smile which is polite but superficial.
French physician Guillaume Duchenne (1806-1875) researched the smile in great detail in 1862.
His findings revealed that an artificial smile used only the large muscles on each side of the face, the zygomatic major, while a genuine smile, induced by a joke, involved the muscles running through the eyes, obicularis oculi, as well. The resulting effect is a visible wrinkling around the corners of the eyes that lies outside voluntary control. You really can't help a happy smile smile - it just bursts upon your face!
Remember, these lines appear with smiling, but don't leave creases unless your skin is deteriorating due to pile-up of dead cells or photo-aging (sun-damage).

In research circles, a genuine smile is still known as a ‘Duchenne Smile’ while a fake smile is a ‘Pan Am Smile’ after the air hostesses in the defunct airline’s adverts.
Duchenne described this "courtesy smile", as "the smile that plays upon just the lips when our soul is sad."
Science has actually proven this to be true - In the late 1950s, 141 female students at Mills College in California agreed to a long-term psychological study. Over the next 50 years they provided reports on their health, marriage, family life, careers and happiness. In 2001 two psychologists at Berkeley examined their college yearbook photos and noticed a rough 50/50 split between those showing a Duchenne or Pan Am smile. On revisiting the data it was found that those with a Duchenne smile were significantly more likely to have married and stayed married, and to have been both happier and healthier throughout their lives.
We now know the "Pan am smile" as the "Botox smile" because the rest of the face smiles but nothing happens around the eyes.
When we say treat "crow's feet" with botox, what we mean is that we are injecting botox into the orbicularis oculi to make it more difficult to scrunch it - something one needs to to be able to do when protecting the eyes by squinting, squeezing eyes tight shut, etc.
So your expressions do affect your emotions, and vice versa - another reason not to focus just on the lines, but on the face and person as a whole! 

Good Luck!


Southampton Physician
5.0 out of 5 stars 6 reviews

Botox will make you look even happier!

Hi TWF,


Thank you for the question.

Please seek out a very experienced injector.  When Botox is artistically injected to treat the crows feet, elevate and reshape the brow and eliminate the "worry lines" between the brows above the nose it will transform your facial appearance.  It will NOT affect your smile, it will make you look warm and welcoming. 

Botox can be a truly transforming treatment.  When done by expert injectors, you will retain facial movement, look natural and look very rejuvenated. 

There are many physicians that can inject Botox but there are few that have the experience and skill that your face deserves.  Seek out the best PS injector in your area and go for a consultation. 

All the best,

Scott K. M. Barr, MD, FRCSC

skinmedispa.ca

Scott Barr, MD
Sudbury Plastic Surgeon
4.8 out of 5 stars 37 reviews

Smile lines and botox

If the Botox is placed appropriately at the "true" crows feet, you should only see a reduction in the lines at the lateral corners of the eyes. Be sure to use an experienced physician to avoid problems. Botox placed lower can cause some "shelfing" of the upper cheek muscle and should be avoided unless that is a preference of the patient. Best wishes.

Pamela Stuart, MD
San Jose Physician
5.0 out of 5 stars 2 reviews

Correcting the crows feet, does it change your smile?

There will be no change to the actual movement of the mouth or cheeks if this injection is done correctly. However, it will change the way you look when you are smiling because the wrinkles are less around the eyes. Most people like this change. It is possible that you don't and keep in mind it will wear off in about 3 months.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Botox, smiling, and crow's feet

I think what you are probably looking for is a low dose Botox injection to soften the crow's feet but not eliminate them. Depending on your baseline muscle activity, I would consider starting with 6 units of Botox on each side. I find that with this low dose, expression is maintained but the lines are softened. 

Botox for the crow's feet

Thank you for your question texaswildflower. Botox is a purified protein used to address wrinkles associated with facial expression such as the crow's feet seen around the eyes when one smiles. This only affects these wrinkles and does not affect the smile itself. For my patients who are hesitant I recommend trying it once. The results last 3-4 months. If they do not like the results then they may choose not to pursue maintenance treatments thereafter. 

Please consult with a doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

Botox injection

The wrinkles around the eyes, so called crow’s feet, usually occur when we smile. They are not bothersome unless they leave creases around your eyes. Botox would enhance overall appearance of your face and especially the area around your eyes, but it would not alter your face expression.

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 22 reviews

Smiling After Botox

Botox is great in treating crow's feet shouldn't impact your expression while smiling. See an expert in injections for best results. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

No effect on expression.

No it won't.  The purpose of this procedure is to eliminate unwanted wrinkles.  There is no effect what so ever on expression.

Sherif El-Salawy, MD
New York Internist

Botox for crow's feet

Botox treatment performed on the crow's feet is an excellent procedure. It should not impact your smile.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.