I often inject Botox into the crows feet area in both younger and older patients.  However, if you have a lot of excessive skin around your eyes in this area, you may be a better candidate for upper and/or lower blepharoplasty surgery.  For prominent crows feet, Botox will lessen but probably not eliminate the lines present.

I have patients over 65 years old who receive Botox regularly.  It will still lessen your wrinkles, but may not eliminate them.  Botox works best around the lateral eyelids "crows feet", frown lines between the brows, and the forehead.

Botox can elevate the brows if it is injected into the muscles of the face that pull the brow down.  However, some patients have very low brows that Botox may not completely correct.  Surgery provides a much more brow elevation than Botox.  Also, Botox lasts approximately 3 months, and a brow lift will provide years of results.

Botox is measured in units, and not necessarily in volume. I personally inject about 5 units into each crows feet region for a total of 10 units. I find that this is enough to provide the desired reduction in crows feet wrinkles.

Botox can be injected by a trained health care professional, but a physician is required to purchase the product and to be responsible for the health care provider who is injecting it. I personally have always performed Botox injections (and all other injectables) myself.

The most common side effect from Botox injection for facial wrinkles is minor bruising and swelling that resolves in a few days. Less commonly, temporary drooping of the eyebrow and/or eyelid can occur. This occurs in less than one percent of patients, and is the result of the Botox spreading from the site of injection to neighboring muscles. Other rare side effects include nausea, headache, and mild flu-like symptoms.

Botox typically lasts about three months before the recurrence of muscle movement. Patients who want to maintain the effects of Botox will receive about four injections per year. In my experience, I have not needed to inject any patients more than this.

Posted by William E. O'Mara Jr., M.D.

Both Botox and Dysport are neurotoxins that block the release of acetylcholine at the neuromuscular junction, thereby inhibiting motor function. This results in temporary paralysis of the muscle, which in the face, reduces wrinkles. I currently use only Botox in my practice.

Posted by William E. O'Mara Jr., M.D.

There aren't any definitive studies on the safety of Botox injection during pregnancy. To err on caution, I do not recommend receiving it during your pregnancy or if you are nursing. This is also stated in the manufacturers guidelines.

Posted by William E. O'Mara Jr., M.D.

Many patients ask me this question. Nonsurgical interventions include injectables such as Juvederm or Restylane or Botox to smooth out wrinkles. Also, chemical peels are helpful to provide smoother skin with smaller pores and less pigmentation irregularities. Also, I perform a lot of fat injection procedures which do not require incisions with sutures. Over time, the face loses volume, and fat is a great substance to "revolumize" the face in areas needing treatment. These procedures are usually done under sedation in an office procedural room. Having said this, many patients do require surgery to attain the desired changes, and avoiding surgery at all costs often limits the potential outcome for the patient.

Posted by William E. O'Mara Jr., M.D.