26y Female- Are 32 units of Botox too much for crows feet? How many are usually recommended for that area? (Photo)

Question

My chief complaint was treatment/prevention of wrinkling around my eyes, mostly present when I smile. My doctor used 32units(16 each side). Is this too much? I don't want to build a tolerance at such a young age. At your clinic, what ranges do you use? What is the average to treat that area?

Emmanuel De La Cruz, MD · Answer

Hello lees190,

Thank you for the picture and your question! I typically use 16 units of BOTOX (8 each side) for crow’s feet on average. But the quantity needed would vary according to the patient’s individual needs. Also, it’s very unlikely but possible to build resistance to BOTOX. In the worst-case scenario, you can switch to substitutes such as Dysport or Xeomin. Hope this helps! Dr. De La Cruz.

Melissa Chiang, MD, FAAD · Answer

When I evaluate crow's feet, I look to see how extensive the wrinkles are when the patient smiles and shuts the eye tight at the same time.  Some people may only have 30 degrees and others more than 180 degrees.  I inject anywhere from 3 units to 18 units per side.  The FDA indication for crow's feet is 24 units (12 per side).  On average, I inject 9-12 units per side.

Mark Berkowitz, MD · Answer

Lees190  Thank you for your question and photograph.  An in person consultation is necessary to determine your best course of action.  It is important  to:See dynamic action of your lidsUnderstand if you are trying to eliminate movement or have natural excursionSee the complete face in actionhave knowledge of past injectionsFor this area, I utilize anywhere from 6 to 20 units depending upon these factors as well as othersall the Best  Dr B

Adam Tattelbaum, MD · Answer

Thanks for your question. 16 units per side is well within the norm. Plastic surgeons will sometimes adjust up or down depending upon your examination. Best wishes.

Trevor M. Born, MD · Answer

Dear lees190Thank you for your question and photo!  The number of units depends on the size of the area that is being treated, the muscle shape, the degree of eyebrow elevation desired and response to prior botox treatments. The range can be 2.5 units to 15 units with the average of 7.5 to 10 units.With Warm RegardsTrevor M Born MD

Spa 35 - Boise · Answer

A face to face consultation would be recommended to assess your face properly, but I usually recommend 6 to 12 units to each eye. Since you are in your 20s, I would expect you to be on the lower end of this range.

Lisa Freeman, MBBS · Answer

The typical range for most people is about 6 to 12 units each side, but I sometimes will do as little as 3 units and rarely 15 units per side. You look like you don’t need a lot of units. Using less units sometimes means that it may not last as long. Next time you could try less units and see the results and how long it lasts. Good luck

Reza Sadrian, MD · Answer

On average I use 20-24 units (10-20 per side) for the crows feet. It does vary from person to person depending on how strong their muscles are. If you feel that you had to much I would recommend discussing your concern with your provider and maybe using less next time.Best Wishes,Dr. Sadrian

Kristin J. Tarbet, MD, FACS · Answer

Hello and thank you for your question. Generally I use between 6 and 12 units for females per side. Everyone is different and could require more. It really is about you and the strength of your muscles. We do not use one dose for all but rather treat your individual needs. Good luck to you with future injections.

John J. Bandeian, MD · Answer

I typically use 10 units per side. However, when the crow's feet are minimal, as yours appear to be, I use less than 10, often between 5 and 8 units per eye. When the crow's feet are severe, I might use up to 14 units per side. I have a few patients who require 20 units per side, but I started them out at 10 units per side and then re-injected them until I determined they would routinely need 20 units per side about every 3-4 months.

26y Female- Are 32 units of Botox too much for crows feet? How many are usually recommended for that area? (Photo)

Answers (18)

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