How to Prevent and Treat Crows Feet

happy-ladyCrow’s feet, or laugh lines around the eyes, can be a challenging area to treat from a cosmetic perspective. On one hand, expressions of joy transmitted through the eyes are beautiful in their own right, but deeper lines and creases in this area can often draw attention to the changes associated with aging and loose skin.

My personal approach is to attempt as much as possible to prevent the lines from becoming deep, or in some cases, even forming to begin with. There are two main methods to achieve this – skincare to plump and stimulate collagen (such as tretinoin or Retin-A©), and Botox® (or equivalent Xeomin® or Dysport®) to reduce the muscle movement in the area and thereby reducing crease patterns. These options can be started at any time, even in the early 30s before real creases have begun. A combination of treatments early can prevent the formation of obvious deeper creases. At this stage, Botox can be performed as little as twice a year before creases have actually formed.

Once the creases are present, the above combinations of skincare and Botox can still make a significant impact and can lessen the appearance of lines around the eyes. Often, this is all that patients are interested in so that they can still appear to have movement while improving their overall appearance. If a more drastic improvement is needed, a series of peels or even fractional laser treatments can be undertaken. The choice of intervention depends on the comfort level of the surgeon and the amount of downtime or recovery the patient is able to give.

If a week of downtime is tolerable, fractional laser resurfacing can be performed relatively aggressively to specifically treat the area around the eyes. Makeup can typically be worn to reduce the appearance of redness during the recovery period. Because we usually cannot be aggressive enough with one treatment to wipe out these lines, a repeated treatment may be needed 3-6 months later. During that period of recovery, Botox can be used to give the skin a continued break from creasing as well.

Facial peels can also be performed, often at varying depths, depending on the amount of recovery or downtime afforded. Often, a peel will have 3 days of recovery and can be repeated every 4 to 6 weeks for a total of 3 to 4 treatments to allow improvement in this area. It is a slower, but less intensive treatment plan. Continuing skincare and Botox through this period will also boost results.

All in all, a multi-pronged approach is often needed to treat the eye area. The good news is that crow’s feet respond to treatment quite well if all options are utilized. Other treatments, such as fillers, can be used as well if indicated, but are not routine as they can be fraught with unexpected complications. With judicious use of Botox and a rigorous skincare routine early, an ounce of prevention is definitely worth a pound of cure.

Come meet with one of the board-certified physicians of the Emory Aesthetic Center. We can discuss your goals and determine what combination of treatment is right for you.


or call us at 404-778-6880 to schedule a consultation.

About Dr. Sethna

anita-sethna-avatarDr. Sethna understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients.

A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.

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