Understanding Crow's Feet and Smile Lines
Target Areas:
- Smile Lines: Lines that form around your mouth when you smile.
- Crow’s Feet: Lines that appear at the outer corners of your eyes.
Why Use BoNTA:
- Reduce Wrinkles: Injecting BoNTA into the orbicularis oculi muscles (muscles around your eyes) can soften or eliminate these wrinkles.
- Prevent Creasing: By relaxing these muscles, BoNTA helps prevent the creasing of skin that happens with facial expressions and muscle tension.
Limitations:
- Static Wrinkles: Wrinkles that stay visible even when your face is relaxed won’t be improved with BoNTA.
- Deep Creases from Sun Damage: BoNTA can’t fix deep lines and wrinkles caused by prolonged sun exposure.
Understanding Crow’s Feet and How to Treat Them with Botox
Why Crow’s Feet Happen
The orbicularis oculi muscle surrounds the eye and is divided into three parts: pretarsal, preseptal, and orbital.
The orbital part extends to the sides and is closely attached to the skin. When this muscle contracts, it causes lines to radiate from the outer corners of the eyes, known as crow’s feet.
As the skin thins and ages, these lines become more pronounced due to repeated muscle movements.
How to Inject Botox for Crow’s Feet
- Preparation: You can use a topical anesthetic and ice, but it’s usually not necessary.
- Injection Sites:
- Make three to four injections around the crow’s feet area on each side of the face.
- Use 8 to 20 units (BU) or 20 to 60 units (DU) per side.
- Be careful to inject 1 cm away from the bony edge of the eye socket, especially above the corner of the eye, to avoid upper lid lag.
- Use a finger of the non-injecting hand to guide by placing it at the lateral orbital rim.
Technique:
- The orbicularis oculi muscle is superficial, so inject just under the skin.
- A superficial dermal injection minimizes bruising while still being effective, due to the wide zone of effect for Botox.
By understanding the anatomy of the orbicularis oculi muscle and following these injection techniques, you can effectively treat crow’s feet with Botox, providing a smoother, more youthful appearance.
Stay Safe
The area around the eyes (periocular area) has many superficial and deep veins that might not be visible through the skin.
Avoiding these veins is crucial to prevent the Botox from being washed away and to minimize bruising.
Post-Injection Instructions
- Bruising Management: The eye area is highly vascular, so bruising can occur. If you hit a vessel, apply firm pressure for a minute or two.
- Ice Packs: Using ice packs after the injection can also help reduce bruising.
Risks
- Incorrect Injection Placement: Injecting too far down and deep under the orbicularis oculi muscle can affect the zygomaticus major muscle, leading to an upper lip droop or an uneven smile.
- Limitations: Inform patients that injections cannot be extended too far downward in this area to avoid complications.
- Line Accentuation: Some patients might notice an increase in lines below the treated area once the lateral lines are addressed.
Practical Tips For Injection
- Allow Some Movement: It’s acceptable to leave a bit of movement for natural facial expressions.
- Choosing the Right Product: Due to its wider zone of effect, some practitioners prefer using BoNTA-ABO (Dysport) for this area.
By following these precautions, post-injection instructions, and practical tips, you can achieve better outcomes and minimize risks when administering Botox injections around the eyes.