There are two types of peri-orbital wrinkles, dynamic and static. The oculoplastic surgeon will determine which predominates at the corner’s of your eyes in order to recommend the best treatment. They will examine all the muscles around the eyes, glabella and forehead by asking you to make faces such as “smile”, “screw the eyes up tightly”, “look angry”, “lift your eyebrows up high” thus testing each muscle group.
The oculoplastic surgeon will determine which predominates at the corner’s of your eyes in order to recommend the best treatment. They will examine all the muscles around the eyes, glabella and forehead by asking you to make faces such as “smile”, “screw the eyes up tightly”, “look angry”, “lift your eyebrows up high” thus testing each muscle group.
They will then use a diagram to show the extent of the areas needing treatment and plan the treatment.
There are several approaches to help reduce crow’s feet:
Improving skin care, skin-resurfacing techniques including laser, micro-focused thermos-coagulation for lifting the skin at the corner’s of the eyes (Ultherapy), Botulinum toxin A injections (Botox), fillers such as Restylane Skinboosters, and eyelid surgery are effective wrinkle treatments.
General skin quality
Tretinoin 0.05% cream (prescription only) to improve skin quality overlying the crow’s feet. It’s regular use helps tighten the overlying skin by laying down new collagen.
Facial fillers such as Skinboosters (hyaluronic acid gel) injected into the outer corner of the eyes help smooth lines and provide dermal hydration hence mask the crow’s feet even for dynamic lines, but are is best used for static deeper lines.
Dynamic lines crow’s feet
Botulinum Toxin A micro-injections using Botox, Azzalure, Xeomin or Dysport are the mainstay of treatment of dynamic lines such as crow’s feet.
The underlying orbicularis muscle contractions visible when smiling or closing the eyelids as fine dynamic radiating crow’s feet are paralysed by tiny injections of botulinum toxin.
4 to 5 small injections of botulinum toxin are used for the crow’s feet on each side. Since the effect is temporary and completely wears of within three to four months, further injections are then required. Other glabella or forehead lines can be treated at the same time as necessary.
Botox works by paralysing the treated muscle at its muscle end plate, as a neuromodulator. The onset of Botox action is 5 to 8 days later and lasts up to 3 months.
The temporary weakening of the small muscles can look very natural. Patients are advised to have injections about three weeks before a major event so the effect is maximal but not “frozen looking”.
The exact number and amount of Botox injections is individualised to each patient needs and clinical findings. All Botox injections are done by the oculoplastic surgeon or the Clinica London nurse under the surgeon’s supervision.
- Botox is a prescription only drug.
Injections are done following full consultation oculoplastic assessment, with full information given to the patient and with signed informed consent.
The Botox injections are done in the clean Treatment Room at Clinica London, in sterile conditions. Clinica London is registered with the care Quality Commission and Save Face.
Other treatments for Crow’s feet
The following measures can help prevent and delay progression of crow’s feet:
- Wear dark glasses
- Avoid very bright sun that makes you screw up your eyes
- Wear the correct glasses so that you are not squinting to look at something or to see someone,
- Apply daily a good quality high SPF 50+ sunscreen against UVA A and B
Static lines – permanent crow’s feet
Resurfacing techniques and volume / hydration boosting helps treat static crow’s feet.
- Trichloracetic acid treatment (TCA) resurfacing to reduce very fine wrinkles
- Fractional laser
- Ultherapy to lift the skin at the outer corner’s of the eyes
- Prevention of worsening by regular Botox injections
Patients find that getting rid of crow’s feet helps them feel “happy but not wrinkly”.
The improved appearance can help you feel better and more confident about yourself and be less aged and tired looking.
Surgery for crow’s feet
With increasing age the skin laxity increases and as well as dynamic and static crow’s feet, there can be hooding of the upper eyelids which may be an indication for eyelid surgery called upper eyelid blepharoplasty.
- Upper eyelid blepharoplasty can reduce crow’s feet with lateral hooding
The crow’s feet can be reduced by removing some of the excess skin and loose muscle which causes additional crow’s feet folds. In upper eyelid blepharoplasty a small amount of overhanging loose fold of skin with a strip of underlying fine orbicularis muscle is removed very delicately under local anaesthetic and the eyelid reconstructed to give a fresh less saggy wrinkly appearance.