What causes wrinkles
known as crow's feet ?
The appearance of crow's feet is inevitable. Their age of onset varies according to several factors.
- Muscular factors : crow's feet result from contraction of the orbicularis oculi muscle, the circular muscle surrounding the eye that contracts whenever we smile. Over time, this muscle becomes increasingly powerful. Initially, the skin creases only when the muscle contracts, before eventually developing permanent creases and resting wrinkles.
- Skin factors : the skin of the eyelids and eye corners is the thinnest on the body. Over the years, it becomes thinner and less resistant to external damage.
- Changes in the temples : fat loss in the temporal area causes the eyebrow tail to droop and additional folds to form.
- Aggravating external factors : these include all factors that accelerate skin ageing. Smoking, sun exposure, poor hydration, lack of sleep and an unhealthy lifestyle.
Severity stages of crow's feet
Crow's feet gradually deepen over time. Several degrees of severity exist, each requiring an appropriate approach.
At first, they may be perceived as expressive and natural. However, when they become more pronounced, they can make the eyes look less bright, particularly when smiling.
A precise assessment by an experienced doctor identifies the most suitable treatment for each severity stage of crow's feet.
At the early stage, these wrinkles appear as fine lines visible during facial expressions, particularly when smiling. At this stage, botulinum toxin injections relax the muscles involved and prevent progression to deeper wrinkles.
At the moderate stage, wrinkles become static, visible even at rest, and the skin begins to show signs of lost elasticity. Treatment involves botulinum toxin and hyaluronic acid injections, the latter being used to restore volume lost through periorbital fat loss.
At the advanced stage, crow's feet are deep and permanent, often accompanied by uneven skin quality and a significant loss of skin thickness. More intensive treatments, such as laser resurfacing or chemical peels, are recommended to stimulate collagen production and improve skin quality.
How can wrinkles at the corners
of the eyes be removed ? Facial exercises
Facial exercises are one of the natural anti-wrinkle techniques used to prevent crow's feet from appearing.
This is a supplementary method that cannot replace botulinum toxin injections.
Ten times a day, for one minute, place three fingers at the eyebrow tail and outer corner of the eye. While forcing a smile, smooth out the area with your fingers.
Daily application of moisturising skincare also helps preserve skin suppleness.
How can crow's feet be corrected ?
Treatments for crow's feet can restore a smooth, youthful eye contour.
Medical techniques such as botulinum toxin and hyaluronic acid injections, as well as fractional and fully ablative laser treatments, effectively eliminate wrinkles around the eyes. These treatments block muscle contraction and stimulate collagen production, improve skin elasticity and visibly reduce signs of ageing. As well as smoothing fine lines and deep wrinkles, these procedures can also even out skin quality and restore its natural radiance. Results are lasting, with a noticeable improvement in skin firmness and suppleness.
Treatment is personalised, but the most frequently performed technique is botulinum toxin injection.
How can crow's feet
be treated with botulinum
toxin?
How does botulinum toxin work on crow's feet ? Botulinum toxin injection blocks activity in the outer part of the orbicularis oculi muscle.
Three points are injected on each side. A slight warm sensation is felt during the injection.
An assessment of muscle activity at rest and during movement, and an examination of the lower orbital area, must precede treatment.
The injection must be tailored to the individual.
Treatment is often combined with injection of the frown line , which also helps open up the eye area.
Results before / after injections of
botulinum toxin into wrinkles known as
crow's feet
Treating crow's feet forms part of a comprehensive approach to the eye area and facial rejuvenation.
Botulinum toxin injections eliminate wrinkles, open up the eye area and give the face a more rested, relaxed appearance. Wrinkles on the lower eyelid will improve slightly.
How long does botulinum toxin last ? The result is visible two days after injection and optimal on the seventh day, lasting five to six months. Dr Romano always schedules an appointment for a free touch-up seven to fifteen days later.
The result must be natural.
Side effects and aftercare
After-effects are almost non-existent : bruising is extremely rare, and slight swelling at the injection points lasts for ten minutes.
Normal activities (apart from sport, hairdresser appointments and eyebrow care) can be resumed immediately afterwards.
A unsuccessful injection for crow's feet can prevent the cheekbone from moving when smiling, cause persistent oedema (swelling) of the lower eyelid and lead to upper eyelid drooping (ptosis). This highlights the importance of consulting an experienced doctor.
How can crow's feet be filled
with hyaluronic acid ?
Hyaluronic acid injections can complement botulinum toxin injections when there is fat loss or skin thinning at the outer corner of the eye.
This technique must be performed by an experienced doctor. Risks include : the product becoming visible as bumps or lumps at rest or when smiling, and persistent oedema (swelling).
The injection is often performed with a cannula, and the acid can be placed beneath the skin or beneath the muscle. The latter injection plane, although technically more complex, is preferable and is the one Dr Romano uses.
The acid used must have very low water affinity.
If there is fat loss at the temples and the eyebrow tail, injecting these areas opens up the eye area and reduces fold formation.
Effects of hyaluronic acid on crow's feet
The result of hyaluronic acid injection is immediate. The hollow at the outer corner of the eye is filled, wrinkles are stretched out, and the eye contour looks refreshed and rejuvenated. Unlike botulinum toxin injection, this treatment does not open up the eye area.
The result lasts around one year. Normal activities can be resumed immediately, and bruising is rare.
How can crow's feet be removed with laser resurfacing ?
Treating crow's feet with fractional and fully ablative lasers is a technique that effectively reduces crow's feet and rejuvenates the skin.
The fractional ablative laser creates microscopic perforations in the skin, stimulating collagen production and promoting skin regeneration while leaving surrounding tissue intact. This method effectively improves skin density and firmness and visibly reduces crow's feet.
In addition, the fully ablative laser uniformly removes the superficial skin layers, improving the overall skin surface and reducing deep wrinkles.
Combining these two modalities, fully ablative and fractional, treats both fine lines and more pronounced wrinkles.
Removing crow's feet
with a peel
A peel can help reduce crow's feet by improving skin quality. Depending on its intensity, it exfoliates the superficial skin layers, stimulates cell renewal and smooths fine lines. This treatment is indicated when the skin has an uneven surface alongside a loss of radiance or firmness. It can be offered alongside botulinum toxin injections to optimise the result. The choice of peel (superficial peel or medium peel) depends on skin thickness, phototype and degree of skin ageing.
Prices for botulinum toxin injections to reduce crow's feet
in Geneva
In Geneva, the price of crow's feet treatment with botulinum toxin injections is 300 CHF for one area in women and 350 CHF in men. It is 450 CHF for two areas in women and 500 CHF in men, then 600 CHF for three areas in women and 650 CHF in men. Where indicated, treatment can be supplemented with an ablative laser, from 350 CHF per session, or a hyaluronic acid injection at 600 CHF per syringe.
Prices vary according to the number of areas treated and the patient's sex, as doses administered to men are generally higher because of their more developed musculature.
Prices for treating crow's feet with botulinum toxin injections start from 300 CHF.
The crow's feet « area » is often treated alongside the frown line to open up the eye area and avoid altering the eyebrow shape.
For women
- One area : CHF 300
- Two areas : CHF 450
- Three areas : CHF 600
For men
- One area : CHF 350
- Two areas : CHF 500
- Three areas : CHF 650
This treatment can also be combined with other techniques, such as an ablative laser (from 350 CHF per session, with an average of 3 to 4 sessions required) or hyaluronic acid injections when there is associated fat loss. A syringe of hyaluronic acid costs 600 CHF.
A phase III randomised trial involving 417 adults assessed the effectiveness of botulinum toxin for moderate to severe crow’s feet. Thirty days after the injections, these lines were absent or mild when smiling in 63.9% of treated patients. Patients also observed an improvement. In this study, the median duration of effect was at least five months, according to the assessment criteria used.
An analysis of two randomised trials involving 1,362 participants examined the duration of botulinum toxin effects on crow’s feet. Among patients showing an improvement at thirty days, it persisted for a median duration of around four months or more, depending on the trial and assessment criteria. Patients who considered the correction more marked also tended to retain its benefits for longer.
A multicentre randomised trial compared two botulinum toxin formulations for treating crow’s feet. Each patient received one formulation on one side of the face and the other on the opposite side. At four weeks, the lines when smiling were absent or mild in around 65% of patients with one formulation and 63% with the other. The two formulations therefore produced comparable results for these lines associated with contraction of the orbicularis oculi muscle.
Frequently asked questions about crow's feet
What is the recovery time after laser treatment for crow's feet ?
Recovery time depends on the type of laser used. With a fractional ablative laser, recovery takes a few days to one week. With a fully ablative laser, the recovery period is longer, at one to two weeks.
Are treatments for crow's feet painful ?
Treatments may cause mild to moderate discomfort. Topical anaesthetics can be used to minimise discomfort.
How important is diet in skin ageing and the development of crow's feet ?
Diet plays an important role in skin ageing and the development of crow's feet.
A balanced diet rich in fruit, vegetables, essential fatty acids and antioxidants helps preserve youthful skin and skin elasticity.
How can crow's feet be prevented ?
To prevent crow's feet, maintaining good skin hydration is essential. A balanced diet rich in antioxidants helps protect the skin from free radical damage. Limiting sun exposure, adopting healthy lifestyle habits and avoiding smoking and alcohol are recommended.
Cosmetic skincare and medical treatments remain the most effective method.
Which cream should be used for crow's feet ?
To treat crow's feet, using specific creams containing active ingredients known for their effectiveness is recommended.
- Retinol : this vitamin A derivative is known to stimulate cell renewal and increase collagen production, reducing the appearance of wrinkles.
- Hyaluronic acid : this powerful moisturiser helps plump the skin by retaining water, which can smooth fine lines.
- Peptides : peptides help repair and strengthen the skin by stimulating collagen and elastin production.
- Antioxidants : creams containing antioxidants such as vitamin C, vitamin E and resveratrol protect the skin from free radical damage and promote cell regeneration.
- Alpha hydroxy acids (AHA) : AHAs gently exfoliate the skin, promoting cell renewal and improving skin texture.
- Growth factors : these natural proteins help repair and regenerate skin tissue, improving the appearance of wrinkles.
At what age should I start treating crow's feet ?
There is no specific age to start treatment. Some people begin when the first dynamic wrinkles appear, generally in their thirties, while others wait until wrinkles become static.
Are the results of crow's feet treatments permanent ?
Results can last from several months to a few years, depending on the treatment performed and skin type. Maintenance sessions are needed to preserve the result.
What role does hydration play in preventing crow's feet ?
Hydration is essential in preventing crow's feet because well-hydrated skin is more supple and less prone to fine lines. Using suitable eye contour products helps maintain a healthy skin barrier and delay signs of ageing. Choosing products containing moisturising ingredients such as hyaluronic acid or glycerine is recommended.
Which facial exercises can help reduce crow's feet ?
Facial exercises can help strengthen the muscles around the eyes and reduce the appearance of crow's feet. For example, regularly practising rapid blinking exercises or contracting the forehead muscles may help tone the periocular area.
What are the risks and side effects of treatments for crow's feet ?
Side effects include redness, swelling, bruising and temporary skin sensitivity. Complications are rare when treatment is performed by an experienced doctor.
