What causes the formation of crow’s feet wrinkles?

Periocular rhytids can develop at different intensities and ages as a result of repeated facial animations, such as smiling and squinting, that cause the orbicularis oculi muscle activity. The skin around our eyes is particularly delicate and susceptible to sun damage (photoaging) caused by ultraviolet radiation (UV rays) and environmental damage including exposure to chemicals in the air and in our daily makeup products. In fact, extensive scientific research has concluded that UV exposure may be responsible for up to 80% of visible signs of aging in the skin, such as wrinkles and lines, dry skin, crepiness, amongst other unwanted aging signs.

The primary cause for wrinkles around the eyes is the natural aging process which results in collagen loss. Collagen is a protein that serves as a building block for our skin, keeping it firm and supple. As we become older, collagen production decreases, reducing the turgor and resilience of our skin and thus, increasing the appearance of crow’s feet. Scientific studies comparing young (18 – 29 year old) skin to old (80 year old skin) found that younger skin holds a higher percentage (78%) of collagen fibers attached to skin cells than that of more mature individuals (58%), providing consistent evidence that older age is associated with reduced collagen synthesis and thus, increased development of rhytids around the eyes. Aging has also been shown to contribute to loss of moisture in the delicate skin around the eyes, which is the thinnest skin in the face, as hyaluronic acid reserves, that naturally hydrate our skin by retaining water, diminish with age.

How does Botox help with the appearance of Crow’s feet?

Botox is one of many neurotoxins that works by blocking the release of acetylcholine, which is responsible for sending nerve signals to the muscles. In turn, the injected muscle in the periorbital region does not receive the signals that would otherwise cause it to tighten, relaxing, paralyzing, or “freezing” the muscle, and reducing facial expressions and unwanted radial lines also known as “crow’s feet”.

When injected into the orbicularis oculi muscles, Botox prevents them from tensing, limiting the smiling and squinting that cause the formation of crow’s feet. Botox and other neurotoxins including Dysport, Xeomin, and Jeuveau can be used on patients with moderate to severe wrinkles to reduce them, and on patients who have not yet developed laugh lines and want to avoid them all together.

Is Botox able to get rid of crow’s feet?

Because Botox is able to eliminate or reduce the appearance of fine lines and wrinkles, it can also be used preventatively to stop these rhytids from forming in the first place. Dr. Schwarzburg works with patients of various ages from their 20s to 60s to maintain their youthful appearance as well as rejuvenate those who have already developed these unwanted, yet inevitable signs of aging.

While these pesky lines often take a toll on our self confidence and can be a harsh reminder of the fact that we are aging, clinical studies comparing the efficacy of onabotulinumtoxinA, more commonly known as Botox, with placebo, have confirmed that Botox significantly smoothes out the appearance of laugh lines in patients with moderate to severe creases when injected intramuscularly into the lateral aspect of the orbicularis oculi muscle.

Botox was FDA approved in 2002 and is deemed safe as an effective cosmetic treatment to keep lines from forming, and fix the appearance of wrinkles, including those that radiate around the eyes. Botox is a great option for those looking to mitigate, stop the formation of, or get rid of their crow’s feet, allowing them to forgo the lengthy downtime and risks associated with more invasive alternatives.

How does Botox get rid of crow’s feet lines?

Crow’s feet, also known as laugh lines, are the radial lines and wrinkles that tend to form around your eyes with age and repeated contractions of the orbicularis oculi muscles that surround the eyes. These muscle flexions occur during certain facial expressions such as smiling and squinting. These periophthalmic lines typically extend from the outer corners of the eyes to the temples, and go hand in hand with the fine lines and rhytids that form on the lower eyelids, due to tension of the inferior palpebral muscle.

Botox is an injectable neurotoxin that blocks the release of acetylcholine, a neurotransmitter that sends nerve signals to muscle groups causing them to contract. When Botox is injected into any given muscle, in the case of crow’s feet, the orbicularis oculi muscle, which circles around the eye, it causes the muscle to relax or “freeze”, which in turn numbs the offending muscle that is responsible for the development of crow’s feet wrinkles. As a result, you will have a fresh and wrinkle free appearance around the eyes.

Will my crow’s feet Botox results look natural?

Yes, your Botox crow’s feet results will look natural! A common concern is that Botox injections around the eyes will look unnatural or fake. While some patients want that featureless look, the number of Botox units used to treat age manifestations along the corners of the eyes can be adjusted to meet your aesthetic goals and needs. After a thorough consultation with Dr. Schwarzburg, he will inject the proper number of units to improve the appearance of your radial lines while maintaining a natural and authentic look.

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How does Botox help fix my crow’s feet?

When you come in for your Botox injections to eliminate your crow’s feet, Dr. Schwarzburg will sanitize the area around your eyes and apply a topical numbing cream to make the overall experience more comfortable. The injection process will take no longer than 10 minutes, making your treatment quick and painless. Botox takes 3 – 5 days to settle, meaning that your results will become evident within that time frame, leaving you with an overall more youthful and brighter appearance.

What is the downtime for crow’s feet Botox?

Downtime with Botox is minimal and typically involves temporary swelling, redness, and sometimes bruising around the injection sites along the crow’s feet. You can resume normal activities immediately after your crow’s feet Botox, though you should avoid exercise and rubbing the treated area for 48 hours post-injection.

Where is Botox injected to get rid of crow’s feet?

In order to properly treat your crow’s feet, it is important to get your Botox administered by a board certified cosmetic physician or dermatologist who specializes in injectables, like Dr. Schwarzburg. This will ensure that the toxin is injected into the right muscle group, in this case, the orbicularis oculi muscle, to erase your crow’s feet. The orbicularis oculi muscle tenses when we smile, creating radiating lines around our eyes. When Botox is injected into these muscles, they become relaxed, leaving you with a flawless and wrinkle-free smile.


The number of units needed to slow down, eliminate, or keep radial periorbital lines from developing, also known as crow’s feet, depends on the severity and depth of the wrinkles and your individual anatomy and aesthetic goals. On average, patients get anywhere from 10 to 40 units total for both eyes. The FDA recommends 12 units per side to treat crow’s feet, though this is variable depending on the above mentioned factors.

Who is a candidate for botox in the crow’s feet?

Botox injections for periocular rhytides are ideal for anyone who is looking to rejuvenate or maintain a youthful glow around the eyes without having to undergo a surgical or any other invasive procedure. While the most common age group to get Botox injections around the eyes ranges 40 – 54, annual statistics have found a 28% increase in Botox periocular treatments in millenials and patients in their 20s. Periophthalmic treatment with Botox is effective and safe to use on both males and females of all ages 18 and up. 

At what age should I start getting Botox?

Botox was originally popular amongst more mature patients in their 40s – 60s to rejuvenate their appearance and get rid of wrinkles and lines that have already developed over time and with age. Today, Botox is used amongst a wide range of both male and female patients of various age groups to treat dynamic (wrinkles that appear whilst making facial movements) and static wrinkles (already existing wrinkles that are evident when the face is relaxed). Patients as young as 20 years old come to see Dr. Schwarzburg for baby botox to stop wrinkles from forming in the first place, keeping their appearance youthful, long term.

In addition to its aesthetic uses, Botox can also be used for medical purposes to treat hyperhidrosis or TMJ.

What is the difference between Botox, Dysport, and Xeomin?

Botox (onabotulinumtoxinA), Dysport (abobotulinumtoxinA), and Xeomin are all injectable neurotoxins derived from the bacterium Clostridium Botulinum. All three share the same mechanisms and qualities, though they do differ slightly in chemical composition.

Botox, Dysport, and Xeomin can be used interchangeably though some differ in concentration. For example, 20 units of Botox or Xeomin, equal 60 units of Dysport. 

While Botox is globally the best known neurotoxin, Dysport and Xeomin have developed their own reputations over the course of the past decade. In rare cases, a patient may develop a resistance towards Botox, in which case Dysport or Xeomin may be used. In other cases, a patient may simply prefer or respond better to one or the other, though overall all three serve the same purposes with results that last 3 – 4 months.

Can Dysport be used to treat the radial lines around my eyes?

Yes, Dysport can be used for the crow’s feet! While some patients prefer Botox, it never hurts to try a variety of neurotoxins, including Botox, Dysport, Xeomin, and Jeuveau, to see if you respond differently to each of them around your crow’s feet.

What other procedures can be combined with Botox for eye rejuvenation?

Aside from Botox, there are various neurotoxins that can be used including Dysport, Xeomin, and Jeuveau. Other treatments that are commonly used to rejuvenate the eye area include dermal under eye fillers such as Juvederm or Restylane to replace lost volume and smooth out under eye hollowness. Skin tightening treatments like Fraxel laser and Secret RF microneedling can be used to smooth the skin surrounding your eyes amongst other regions of the face and body. Smooth PDO threads may also be placed around the eyes to stimulate collagen production to keep the delicate skin around the eyes smooth and supple.

Can Juvederm filler be used in conjunction with Botox?

Yes, Juvederm can be used alongside botox if needed to fill in deeper lines or crow’s feet that cannot be addressed using the toxin alone. In addition, Juvederm or Juvederm Vollure can be used under the eyes to lose the under eye circles caused by lost volume or hollowness that may occur with age or genetically. Juvederm may be used in various regions of the face depending on the areas you want to treat and your aesthetic goals.

Are there side effects associated with Botox?

Botox treatment is minimally invasive and thus, comes with limited risks or side effects. Immediately after your injections, you may have some redness and swelling around the injection points, which will subside within 1 hour. Bruising can occur on the next day, in which case Dr. Schwarzburg recommends applying a warm compress to mitigate the bruising and speed up the healing process. To avoid any major side effects or complications, you should always get your botox injections administered by a board certified plastic surgeon like Dr. Schwarzburg who has an excellent understanding of your anatomy and has perfected the intricacy of botox injections.

How much will Botox cost to treat my crow’s feet?

The cost of your Botox for crow’s feet varies depending on the number of units needed to achieve your desired result. In addition, a board certified physician may charge higher than a nurse practitioner. The geographical location of your provider may also affect the price, as larger cities such as New York or Los Angeles may have higher rates than more rural areas. On average, the cost of Botox to treat crow’s feet ranges $200 – $700.

How long does it take to see my results after getting Botox for crow’s feet?

Depending on your individual response to the treatment, Botox typically takes 3 – 5 days. In some cases you will continue to notice a difference in your crow’s feet over the course of the 2 weeks following the initial injection.

How long do Botox crow’s feet results last?

The results from intramuscular Botox injections to the orbicularis oculi muscles are not permanent and last an average of 3 – 4 months. Clinical studies testing the binding of Botox to neuro receptors, internalization, translocation, and acetylcholine blocking have concluded that visible effects of Botox in the periocular region take place within 4 days after the injection process. The duration of the effects around the orbits is variable depending on each patient’s individual and biological response to the medication, but typically lasts up to 90-120 days.

Can I get rid of under eye circles using Botox?

Botox can be used to get rid of crow’s feet, though it will not help with under eye circles. Under eye hollowness is caused by lost volume in the tear troughs which can occur with age as fatty tissue in the face begins to diminish. Tear trough filler can be injected using hyaluronic acid based fillers, such as Restylane to fill in this hollowness, leaving you with brighter and smoother under eyes.

Will my crow’s feet be permanently gone after my Botox treatment?

Because botox only lasts 3 – 4 months, it will not permanently fix your crow’s feet. However, if you continue to get regular follow-up treatments, you can avoid the results from fading, making them semi-permanent. When used as a preventative tool, Botox can keep your crow’s feet from developing as a whole.

What will I look before and after Botox for crow’s feet?

After Botox is injected into the periorbital region and has settled over the course of 3 – 5 days, you will notice a reduction or full elimination of rhytids and lines around your eyes. The facial wrinkles that typically surround your eyes in a fan-like fashion will be less noticeable both statically and dynamically, meaning that the wrinkles will be less distinguishable whether your face is relaxed or animated.

Why is Botox so popular to treat crow’s feet?

Botox has grown to become the most popular cosmetic treatment across the globe due to its minimally invasive nature, limited downtime, and effectiveness, particularly to treat periophthalmic lines that form around the eyes. Known as a “lunch break procedure” Botox for crow’s feet can be quickly and safely performed by a skilled and experienced cosmetic injector, to stop the appearance of radial laugh lines in both men and women ages 20 and up in as little as 15 minutes. Botox alongside other neuromodulators can be used not only to get rid of crow’s feet, but also preventatively to keep them from becoming visible in the first place, making Botox a win-win for anyone who wishes to steer clear of unwanted age manifestations around the eyes.

How can I get started with my crow’s feet Botox?

Dr. Schwarzburg is a board certified cosmetic physician with over a decade of experience, specializing in minimally invasive procedures. He treats a wide range of patients of various ages, genders, and demographics, all of which are treated individually with a uniquely designed plan that meets both their aesthetic and financial needs. His boutique medical spa, Skinly Aesthetics, is located on the Upper East Side of Manhattan, where you can schedule your one on one consultation and acquire your personalized treatment plan by contacting (212) 774-4264 or emailing info@skinlyaesthetics.com