Aesthetic Medicine

Crow's feet — Lateral canthal lines

Crow's feet are lines radiating from the outer corners of the eyes caused by the contraction of the orbicularis oculi muscle when smiling or squinting, while under-eye wrinkles stem from thin skin losing its elasticity. Initially, they only appear during facial movement (dynamic wrinkles), but over time, they become permanently visible even at rest (static wrinkles). Dynamic wrinkles respond well to botulinum toxin, whereas static wrinkles require additional modalities such as skin boosters, RF, or skin resurfacing lasers.

Medically reviewed by BS.Ths.CKI Kim Kha — BonBoz Clinic

Why do crow’s feet wrinkle earlier than other areas?

The skin around the eyes is one-third the thickness of cheek skin, has fewer oil glands, and sits directly over the orbicularis oculi muscle, which moves tens of thousands of times a day (blinking, squinting, smiling). With every muscle contraction, the skin folds along the same lines; as collagen depletes with age and sun exposure, the skin loses its snapback capacity, gradually turning these fold lines into permanent, etched-in wrinkles.

Dynamic vs. static wrinkles — how to tell them apart

Look in the mirror with a relaxed face: if the outer corners of your eyes are smooth and lines only appear when you smile, you have dynamic wrinkles. If the lines remain visible at rest, they are static wrinkles—meaning the skin has lost its structural integrity along the fold lines. Static wrinkles almost always coexist with a dynamic component, so treatment typically requires a combination approach. Fine, cross-hatched under-eye wrinkles (crepey skin) indicate thin, dry, and inelastic skin, which differs from tear troughs (volume deficiency) and under-eye fat pads.

Why doesn't Botox erase static wrinkles?

Botulinum toxin relaxes the orbicularis oculi muscle so the skin no longer folds, eliminating dynamic wrinkles and gradually softening shallow static lines over time as repetitive creasing stops. However, deeply etched wrinkles require local structural restoration: intense hydration and collagen stimulation via skin boosters, microneedling RF, or laser therapy. Topical creams can hydrate and smooth the skin's surface, but they cannot replace these clinical mechanisms.

What determines the degree of improvement?

The stage of the wrinkles, skin thickness and hydration levels, habitual squinting (uncorrected myopia, sun exposure), smoking, and treatment consistency. Botulinum toxin results last 3–4 months; skin boosters require an initial series followed by maintenance sessions; laser and RF therapies require a structured protocol based on the wrinkle severity.

How does BonBoz approach crow's feet?

An aesthetic dermatologist directly examines and evaluates the skin under magnification, stages dynamic vs. static wrinkles, and assesses skin thickness alongside any coexisting tear troughs or under-eye bags to ensure targeted treatment. Tailored protocols by stage: low-dose botulinum toxin for dynamic lines (preserving natural facial expressions when smiling); combined with skin boosters, microneedling RF, or laser therapy for static lines; or referral to a plastic surgeon if significant skin laxity requires surgical excision. Doctors perform all injections and procedures directly; longevity and potential risks are clearly explained in advance.

Severity levels

1

Dynamic wrinkles — appear only when smiling

Skin remains smooth at rest. Micro-dose Botulinum toxin targeting the orbicularis oculi muscle, combined with sun protection and hydration.

2

Superficial static wrinkles — visible at rest, fade when stretched

Combination of botulinum toxin and skin boosters to hydrate and stimulate localized collagen production.

3

Deep static wrinkles with thin, sagging skin

Requires a treatment plan of microneedling RF or resurfacing laser; in cases of significant excess skin, consider lower blepharoplasty.

When should you see a doctor?

  • Crow’s feet remain visible at rest despite regular moisturizing — they have transitioned into static wrinkles, where creams alone are no longer enough.
  • You squint frequently due to uncorrected vision — adjust your eyewear prescription first, or the wrinkles will quickly return.
  • The under-eye area shows wrinkles combined with hollows or bags — these must be properly differentiated to avoid treating the wrong target.
  • You have had Botox injections elsewhere that resulted in drooping eyelids, an asymmetrical smile, or prolonged dry eyes.

How BonBoz treats it

Botulinum Toxin (Botox) for Crow's Feet

Low-dose injection into the orbicularis oculi to soften dynamic wrinkles while preserving natural facial expressions; lasts 3–4 months.

Learn about this method →

Hydrating Skin Booster

Microinjections of non-crosslinked HA to deeply hydrate and improve the smoothness of the delicate under-eye skin.

Learn about this method →

RF Microneedling

Delivers RF energy into the dermis via microneedles to stimulate collagen for static wrinkles and crepey under-eye skin.

Learn about this method →

Cost guidance

Botulinum toxin is priced per injection area; skin boosters and RF microneedling are priced per session. Physicians will provide a quotation based on your personalized treatment plan following a skin analysis; our cost estimation tool provides a reference price range for non-surgical aesthetic treatments.

The final price follows the doctor’s recommendation after an in-person exam. A confirmed quote has no hidden extras.

Chân dung BS.Ths.CKI Kim Kha

BS.Ths.CKI Kim Kha

Aesthetic Dermatology

  • Graduated as a General Practitioner — Tay Nguyen University (2018)
  • Specialist Level I in Dermatology — Pham Ngoc Thach University of Medicine, degree awarded in 2025
  • Medical Practicing Certificate No. 009784/ĐL-CCHN — Issued by the Department of Health of Dak Lak Province on 15/10/2021
  • Over 8 years of experience in aesthetic dermatology practice (since 2018), including over 4 years of practice with an official Medical Practicing Certificate
  • Primary Specialization in Plastic and Reconstructive Surgery; Certificates in Dermatological Procedures & Minor Surgery, Microsurgery, and Lasers & Light Therapies in Dermatology
  • Certificates in Dermal Fillers, Botox, and Thread Lifts; Certificates in Emergency Resuscitation and Infection Control
  • Formerly practiced at the Aesthetic Dermatology Unit — Post and Telecommunications General Hospital (2019–2021) and Venus Sunrise Clinic (2022–2024) before joining BonBoz Clinic (2025)
  • Former lecturer in Aesthetic Dermatology Theory at Ana Aesthetic Training School (2018–2019)
  • Over 5,000 clinical dermatology cases treated
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Frequently asked questions

Will Botox for crow's feet make my smile look stiff?

With a low dose and precise placement, the orbicularis oculi muscle is only partially relaxed, allowing you to maintain a natural smile while simply reducing wrinkles. High doses or injecting too low can impair the lifting of the cheek when smiling.

How long does Botox for crow's feet last?

Typically 3–4 months; it may be shorter for individuals with hyperactive facial muscles. Regular treatments help gradually soften shallow static lines over time.

How does a skin booster differ from filler?

Skin boosters consist of non-crosslinked, low-viscosity hyaluronic acid (HA) administered via micro-injections to hydrate and stimulate collagen production, without adding volume or sculpting the face. Dermal fillers are thicker and designed to restore lost volume, such as in the tear troughs.

Do anti-wrinkle creams really work?

Moisturizers, retinoids, and sunscreens help keep the skin hydrated, increase skin thickness over time, and slow down the formation of new wrinkles; however, they cannot erase etched-in static lines or affect underlying muscles.

How are fine, crepey under-eye wrinkles treated?

These are caused by thin, dehydrated skin. Skin boosters and microneedling RF are more effective than Botox; these should be combined with rigorous moisturizing and strict sun protection.

What are the risks of Botox for crow's feet?

Minor bruising at the injection site and temporary dry eyes; rarely, eyelid ptosis (drooping) or an asymmetrical smile if the product diffuses into adjacent muscles. Doctors use precise placement and conservative doses to minimize these risks.

At what age should I start?

It is not determined by age, but by skin condition: start when dynamic wrinkles become noticeable and bother you. Starting early with low doses helps prevent deep, static lines from forming.

Does squinting due to nearsightedness accelerate wrinkle formation?

Yes. Squinting causes continuous contraction of the orbicularis oculi muscle; wearing the correct prescription glasses is a simple preventive measure that should be addressed before undergoing any aesthetic treatment.

Can laser treatments damage the eyes?

The periocular area is always protected with corneal eye shields and treated using appropriate parameters; procedures must be performed by a qualified doctor and should never be done without proper ocular protection.

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