A powerful and protective muscle surrounds the eye. In a split-second, it can squeeze the area shut, completely closing and shielding the pupil from harm. It’s also a very expressive muscle. Squinting, smiling and other facial emotions engage this area of the face hundreds of times per day. With decades of folding and refolding skin can develop noticeable wrinkles. Crows feet are wrinkles that radiate from the corners of the eyes. They are harmless and completely natural, but can make us appear older than we are, and more tired than we actually feel.

Eye cremes, peels and cleansers can improve the outer layers of the skin, while collagen-inducing skin care treatments like Pelevé radio frequency treatments and SkinPen micro-needling treatments can improve deeper layers of the dermis.

A somewhat more aggressive approach is to address the underlying muscles themselves. When correctly applied, Botox injections relax the muscle around the eye, softening our expressions, to create a younger and more pleasant appearance. Botox is highly versatile; you can treat different areas, add more or less, and fine-tune the results over time. With the muscles relaxed, wrinkles are less pronounced and expression lines begin to fade. Botox is not permanent, and follow-up treatments will need to be scheduled every 3–4 months. A Botox treatment averages $350–700, depending on how much of the serum is used.

It’s important not to over-treat any area with Botox. The goal is to only soften expressions. An over-application of Botox can leave us with an unnatural lack of expression, which will look far worse than a few wrinkles. This is one of the primary reasons Botox should only be applied by expert injectors with surgical experience and in-depth knowledge of facial anatomy.

Some doctors offer surgical solutions, sometimes referred to as “permanent Botox.” We discourage patients for taking this route for a number of reasons, it’s expensive, involves greater risk, has a longer recovery time and is difficult to get right. The procedure involves surgically removing certain muscle fibers to permanently imitate the effect of Botox. But unlike Botox injections, if there’s a bad result, the problem will not fade over time. If the appearance looks under-treated or asymmetrical, another surgery would be required. If the effect looks over-treated, that can be difficult or even impossible to reverse.

For optimal results, we recommend using Botox to soften expressions, and combining skin care to improve the health, elasticity, tone and texture of the skin around the eyes.

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