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.

You should check with your surgeon concerning their particular postoperative instructions to ensure that you are doing exactly as they say. I usually ask patients to refrain from strenuous activity for 2 to 3 weeks after eyelid surgery. Patients can wash their face lightly with a washcloth over areas away from the surgical sites the day after surgery, but need to wait about a week until sutures are removed to wash the entire face.

Sometimes, small subcutaneous veins can become visible beneath the skin after lower blepharoplasty. In my experience this occurs in a small subset of patients. These veins can be treated by making a small incision in the skin and cauterizing the vein. If necessary, I will perform this minor procedure in an office setting under local anesthesia.

Sagging of the cheek fat pad can sometimes be one of the first signs of facial aging. Depending on the severity of your case and how your lower eyelid joins your cheek fat, you may be a candidate for nonsurgical intervention, such as injection of a filler into the cheek and/or lower lid/cheek groove. If you have a significant amount of sagging of the cheek fat, and relative proportionality of the rest of your face, particularly your brows, jawline and neck, I would definitely consider recommending an isolated mid face lift with possible lower blepharoplasty at this point in time.

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