Crow's feet treatment: Botox dosing, filler, and what actually works

Crow's feet are among the first dynamic wrinkles to appear and typically the most responsive to treatment. Here's a practical guide to what works, what's added when Botox alone isn't enough, and what to realistically expect.

What causes crow's feet

Crow's feet are formed by the orbicularis oculi — the ring-shaped muscle that encircles the eye and controls both squinting and blinking. When this muscle contracts (during smiling, squinting, or eye movement), the skin at the outer corner of the eye folds repeatedly. Over years, these repeated movements etch permanent lines into the skin.

Two categories of crow's feet:
Dynamic lines: Visible only with expression (smiling, squinting). Primarily a muscle activity problem.
Static lines: Visible at rest, etched into the skin. Both a muscle activity problem and a skin quality/collagen problem.

Early crow's feet are purely dynamic. Established crow's feet have a static component that doesn't fully resolve with Botox alone.

Botox for crow's feet

Botox (or Dysport, Xeomin, Daxxify) is the primary treatment for crow's feet. By relaxing the orbicularis oculi in the lateral (outer) eye area, the muscle contracts less — the lines smooth at rest, and expression lines are minimized.

FDA status: Crow's feet is an FDA-approved indication for Botox and Dysport.

Dosing

| Sex | Typical dose per side | Total |
|---|---|---|
| Female | 8–12 units Botox | 16–24 units |
| Male | 10–15 units Botox | 20–30 units |

Dysport dose: Multiply by approximately 2.5–3 for equivalent effect.

Lower doses preserve natural smiling expression. Higher doses produce stronger smoothing but may flatten expression slightly. Experienced injectors find the patient-specific dose that balances results with preserved natural movement.

Placement

Injection points are typically 3–4 points per side, distributed along the lateral orbital rim (outside the bony orbit, into the muscle). Injections too close to the orbital rim increase the risk of lower eyelid descent or bruising.

"Bunny lines": The small lines that appear on the nose bridge when squinting or wrinkling the nose (nasal dorsum lines). These are caused by the nasalis muscle. If prominent, 2–4 units of Botox into the nasalis during the same session prevents the "chasing effect" where treating one area makes an adjacent area more obvious.

What Botox achieves for crow's feet

Dynamic lines smooth significantly — often nearly invisible during expression
Mild improvement in static lines (less muscle tension = less skin folding = some static improvement over time)
Results appear at 5–7 days, peak at 2 weeks
Duration: 3–4 months

When static crow's feet need more than Botox

For patients with established static lines that remain visible at rest even after Botox, additional treatments help:

Soft filler for static crow's feet

Soft, thin HA filler (Belotero Balance, Restylane Silk, or highly diluted Juvederm) placed precisely along static crow's feet lines can fill the residual etching. This is a delicate injection:
Volume used is tiny: 0.1–0.3 mL per side
Filler must be very soft (no thick structural fillers in this area — they'll lump or show)
The risk of Tyndall effect (blue-grey discoloration from superficial placement) is relevant in this thin-skinned area

Filler for crow's feet is most appropriate for patients with moderate-to-deep static lines that persist despite Botox. It's not a first-line approach.

RF microneedling or laser resurfacing

For significant skin quality issues at the lateral canthus (crow's feet area), energy-based devices address skin collagen directly:
RF microneedling: Improves skin quality and stimulates collagen in the surrounding skin
Fractional non-ablative laser (MOXI, Fraxel): Similar indication
Topical retinoids: Daily tretinoin or retinol over months improves skin quality and can reduce surface crow's feet depth

The "complete eye area" treatment approach

Many providers approach the eye area as a unit. Beyond crow's feet specifically:

| Concern | Treatment |
|---|---|
| Dynamic crow's feet | Botox laterally |
| Forehead/brow | Botox (carefully — brow position matters) |
| Under-eye hollowing | Soft HA filler |
| Under-eye puffiness/bags | Surgery (blepharoplasty) or careful lower lid assessment |
| Upper lid heaviness/hooding | Brow lift (Botox or surgical) |
| Periorbital skin quality | RF microneedling, laser, topical tretinoin |

Treating only the crow's feet in isolation can sometimes make adjacent untreated areas more obvious by comparison. A provider who assesses the full periorbital area rather than just the spot you mentioned may produce better overall results.

Cost

| Treatment | Cost |
|---|---|
| Botox crow's feet (16–24 units) | $200–$400 |
| Combined forehead + glabella + crow's feet | $400–$900 |
| Soft filler for static crow's feet | $500–$1,000 |
| RF microneedling (eye area / full face) | $800–$2,000 |

Aftercare specific to the eye area

Avoid rubbing the eye area for 24 hours post-Botox
Do not apply pressure (eye masks, pressure goggles) for 24 hours
Sleep on your back if possible for the first night
Cold compresses reduce bruising (the lateral orbital rim is a moderate bruising area)
Avoid aspirin/NSAIDs for 1 week pre-treatment if bruising is a concern

Questions to ask your provider

Based on my crow's feet pattern (dynamic only, or static component), what combination of treatments do you recommend?
What dose do you typically use for crow's feet, and how do you balance smoothing vs. preserving expression?
Should I be treating adjacent areas at the same time for a balanced result?
For my static lines — would you recommend adding filler, laser, or just continuing with Botox over time?
What's your touch-up protocol if I feel my crow's feet Botox dose is slightly off at 2 weeks?

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