CosMedicList logo Your one stop shop for cosmetic enhancement

Crows feet

Question posted by Marc from Milton

What’s the best way to remove crows feet and signs of aging from my face?

Doctor's Response

Are you a plastic surgeon? Sign In or Register to answer.

2 thoughts on “Crows feet

  • Dear Marc,

    Thank you for your clinical post.  Crow’s Feet are the lines and animation expression crevices at the side of they eyes together with frown lines or the Number 11s between the brows, horizontal worry lines, deep smile lines and Marionette lines around the mouth are some of the common areas that patients present as they experience facial aging.  When you combine this with loss of volume and sunkenness under the eyes or cheeks, sun damage or photoaging and brown spots, broken capillaries and large pores together with droopiness of the cheeks you get classic 3D aging.  3D is referred to deflation, descent and deterioration.  Depending on your age and the extent of 3D aging, you may require one, two or three D therapy.  For simple deterioration such as brown spots, photo damage, fine to moderate lines without significant deflation or descent, most patients will start with the use of Botox to reduce hyperactive muscles causing the lines and wrinkles together with laser and light and energy based treatments such as intense pulsed light for correction of brown spots and broken blood vessels and bulk heating and radio frequency treatments to tighten skin and firm texture.  These combination treatments are performed as an outpatient in under an hour and have essentially no downtime.  After 3-5 treatments most patients an look 4-5 years younger.

    So, with significant deflation loss of volume in addition to the aforementioned treatments one might start exploring the use of soft tissue fillers.  Soft tissue fillers can bring back structure to hollow under eyes, hollow temples, hollow cheeks to the smile lines and Marionette lines around the mouth, as well as to the lips themselves.  Commonly used fillers include Juvederm, restylane, Radiesse, Sculptra and even patients own fat can be harvested and reinjected safely.  With restoration and volume the deflation has been corrected leaves only descent.  Descent is usually the last of the aging signs and symptoms of the 3D diagnosis and descent can be treated with energy devices that tighten such as radio frequency devices Forma, Exilis, Venus Freeze or radio frequency needle-based devices such as Fractora on the Profound or subdermal heating such as Smartlipo, Precision TX or FaceTite.  These non-excisional heating techniques will result in a mild to moderate but noticeable lifting of the cheeks and jawline.  Minimally invasive techniques with more significant lifting capacity include thread lift or suture suspension or mini lifts and these are usually reserved for more advanced soft tissue descent.

    This hierarchal treatment of 3D aging can give you many options to create the type of natural and youthful fresh look that you are seeking.

    I’m sure you’ll get a very pleasing aesthetic rejuvenation and best of luck.

    I hope this information has been of some assistance.

    For more information, please review our  botox page and soft tissue fillers page.If you’d like to schedule a consultation please call
    SpaMedica at (416) 922-2868 or visit us at our website at http://www.spamedica.com and fill out an e-mail
    online consultation request form.

    R. Stephen Mulholland, M.D.

    Certified Plastic Surgeon

    Yorkville, Toronto

  • Usually for these types of wrinkles we use Botulinum toxin (botox) with very good results. Typically last around 4 months.

Additional Information

Botulinum Toxin aka Botox

Read about the procedure

Filter By Category

Recently Answered