25, undereye wrinkles, crows feet when smiling. What treatment would be best? If its botox, how many units would I need? (photo)

Question

Despite my age, I have developed lots of fine lines and wrinkles under my eyes. This is due to many reasons: poor skin care until I was 24, very fair skin and lots of squinting over the years from not wearing sunglasses when I probably should have been. I've reached a point where my lines when I smile are so noticeable that I want to do something to treat them. Thanks!

Peter N. Butler, MD, FACS · Answer

Using a good eye cream, and trying a small dose of Botox are good options for your age. Based on your pictures, you shouldn't need more than 8-10 units per side.

Yannis Alexandrides, MD, FACS · Answer

I believe you could benefit from a combination approach with the use of Botox in the crow's feet area which could reduce some of the wrinkling, as well as Fraxel to address wrinkles that are not reduced with Botox. I'd also recommend the Space Defence Bright Eye Lift Gel by 111SKIN - The soothing gel is designed to reduce the appearance of fine lines and wrinkles, brighten dark circles and minimise puffiness. In addition, the Celestial Black Diamond Eye masks provide a targeted, time release formula, with immediate anti-ageing results, hydrating the under eye area.

Jason Emer, MD · Answer

A combination approach will give the most improvement. Botox, fillers, lasers, and microneedling/PRP can improve 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

Bahman Guyuron, MD · Answer

You would be a good candidate for combination of Botox injection, laser treatment, fat injection (for the stem cell effect) and vigorous skin care program to revers these early changes and restore and maintain the youthful glues that belongs to a 25 year old.

Michael I. Echavez, MD · Answer

Botox is commonly used to treat crow's feet.  You would mainly notice a difference when you are smiling compared to when you are not smiling.  The lines on the sides of the eyes that form when you smile should not show up as much after the treatment.  Botox will not have that much affect on lines beneath the eyes however.  I would say that you would need between 20-25 units for treating your crow's feet.

Wayne Wertheim, MD · Answer

although there are many therapies that can be suggested the biggest bang for the buck will be botox or other neuromodulator (ie dysport). As for the crows feet you likely need 10 units on each side. We have also been successful with small doses of neurotoxin in the lower lid. This should be preceded by a "snap test" to show that there is elasticity in the area. If the elasticity is poor you could have a droop in the lower lid so make sure your injector is experience with this. Usually we use only 2 units under each eye.
If this doesnt give you the results there are many choices that can be discussed with your dr.

Martie Gidon, MD, FRCPC, FAAD · Answer

Botox can help minimize movement and soften crow's feet.  Fifteen to 20 units are commonly used. Sun protection and good skin care will also help.

Melvin Elson, MD · Answer

Botox would be the best treatment for your issue. the crow's feet are easy and only takes about a total of 12 units, but under the eyes requires a great deal of skill so be sure you see a qualified dermatologist who is experienced in the use of Botox

Steven Wallach, MD · Answer

Botox to the crow's feet might be very helpful to you. I usually use about 15-20 units for both sides.  Good luck.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  Botox can reduce the wrinkles in the crow's feet area.  However wrinkles beneath the eyelashes cannot be treated with Botox.  I used 12.5 units of Botox to treat the upper and lower crow's feet on each side for a total of 25 units.

25, undereye wrinkles, crows feet when smiling. What treatment would be best? If its botox, how many units would I need? (photo)

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