Remove crow's feet

How do crow's feet develop?

Man communicates on all senses. The eyes are the focus. One look says more than a thousand words. At the first meeting, men and women judge the attractiveness of a counterpart by its appearance. Large, round eyes and soft skin are particularly attractive. In the course of life or due to a predisposition, the elasticity of the skin and the muscles at the outer corner of the eye can diminish. Sunlight and pollution of the air we breathe reduce the elasticity of the skin. The content of elastin, proteoglycans and water decreases with age. The skin is under the influence of alternating tension and relaxation of the eye muscles. Over the years, fibroblasts and collagen fibres orient themselves parallel to the direction of traction. The skin becomes tired and deeper wrinkles develop. The wrinkle lines gradually run from the outer corner of the eye to the temple. Cosmetics hardly influence the processes under the skin.

What's the difference between smile lines and crow's feet?

Laugh lines recede with a neutral facial expression. They are a sign of joie de vivre. Facial wrinkles convey feelings such as anger, sadness or tiredness. Due to the aging of the skin, wrinkle lines remain. The wrinkles fake feelings that the person does not feel. Crow's feet are deep, permanent wrinkles on the eye compress that awaken a tired facial expression. Crow's feet, forehead wrinkles and frown lines are among the three most frequently perceived facial wrinkles. Studies suggest that the treatment of these facial wrinkles has a positive effect on mood.

How are crow's feet treated?



The injection of small amounts of Botox into the outer round eye muscles relaxes overactive muscle parts. The overlying skin becomes calm and smooth. The Botox treatment of facial wrinkles is the most common aesthetic treatment at all. Crows' feet can be reliably repaired or reduced with Botox. The facial expression appears more relaxed. Only rarely are side effects to be expected. If carried out correctly, patients are very satisfied after Botox treatment.

How is the treatment of crow's feet performed?



A Botox treatment at CenterPlast is always preceded by a comprehensive examination and consultation. The medication botulinum toxin type A (BTX A) is produced as a dry substance. The Botox is dissolved and diluted with saline solution in vials before use. The plastic and aesthetic surgeon will ask you to tighten your facial muscles to the maximum in order to identify the injection points. As you close your eyes, the points are marked with a Cajal pencil. Anesthesia is usually not required when treating with botulinum toxin. The cannulas used have a diameter of 0.2 to 0.3 millimetres so that the puncture is hardly painful. The Botox is administered over two to three punctures per side into the muscle.

What should I watch out for when treating crow's feet with Botox?

The following hygiene measures are always observed at CenterPlast Saarbrücken:

  •     Clean work surfaces treated with a disinfectant.
  •     Hygienic hand disinfection.
  •     Use only sterile disposable syringes and cannulas.
  •     The use of sterile single-dose ampoules.
  •     Checking the original closure for intactness and expiration date.
  •     A thorough alcoholic skin disinfection.
  •     Storage of the products according to the manufacturer's instructions under temperature control and documentation.

Of course, we only use approved drugs whose composition, purity and manufacturing process have been checked by the European Medicines Agency.

Who is a Botox treatment for crow's feet suitable for?

More than five million Botox treatments were performed worldwide in 2017. Every patient undergoing aesthetic treatment has different personal and individual needs. Mid-deep to deep crow's feet occur between the ages of 35 and 65. A Botox treatment can help to achieve a fresh and rested appearance. During pregnancy or breastfeeding, Botox treatment should be avoided for reasons of caution. A Botox treatment should not be carried out if blood thinners have been taken beforehand or if there is a tendency to scar growth. Treatment is not recommended in cases of immunodeficiency or rare neurological diseases (e.g. amyotrophic lateral sclerosis, myasthenia gravis, Lambert-Eaton syndrome). Allergies to Botox preparations are possible, but very rare.

What should you consider before a Botox treatment of crow's feet?

The Botox treatment for crow's feet is uncomplicated and fast. You can return to your normal daily routine immediately after the treatment. The areas to be treated are disinfected before use. Therefore, do not apply make-up before treatment.

What should you keep in mind after crow's feet treatment?

Some doctors recommend that patients should not lie down for six hours after treatment in order to reduce the likelihood of the Botox spreading undesirably. In fact, there is no evidence that a change of position can lead to an unwanted spread. Botulinum toxin is absorbed by the nerve cells after five to ten minutes of contact with the nerve cells. An unwanted spread is therefore unlikely.

Many doctors suggest massaging the treated areas to increase Botox absorption and prevent swelling. However, other doctors advise caution to prevent unwanted spread. There are currently no studies on the effect or side effect of a massage of the injection points. The plastic surgeons at CenterPlast therefore recommend that you behave normally.

After a Botox treatment, cooling is often used. The cooling leads to a narrowing of the vessels and reduces the pain after the injection as well as the risk of swelling. At twenty degrees Celsius, the botulinum toxin cannot penetrate the cells. Cooling can therefore impair the effectiveness of Botox treatment. We therefore recommend short-term cooling if the skin reacts sensitively to the puncture.

What can you expect during a consultation about crow's feet?

During the initial consultation, your goals will be discussed and the characteristics that distinguish you will be examined in detail. Your skin elasticity, the type of wrinkles, the number of wrinkles and the depth of wrinkles will be analysed. Changes in the skin caused by sunlight, vascular drawings or facial asymmetry are taken into account during planning. The elasticity of the lower eyelid is also examined to prevent the lower eyelid from stepping down after a treatment. The contours of the face and the facial proportions are evaluated in order to achieve a natural and balanced treatment result. A treatment plan is drawn up that takes your priorities into account. The plastic surgeons will explain the expected results and possible risks to you in detail. Photos will be taken before and two weeks after the treatment to monitor success.

What are the risks of treating crow's feet?


A Botox treatment is very low risk. Occasionally the punctures lead to skin irritation, which disappears after a few minutes. If a vessel is injured during the injection, bruising may occur and disappear after a few days. Depression of the lower eyelid or asymmetry may occur. Larger amounts of botulinum toxin (100 to 700 E Botox®) are used to relieve muscle cramps. This can lead to undesired effects such as antibody formation and headaches. These side effects are very unlikely in the treatment of crow's feet (20 E Botox®).

How much Botox do I need to treat crow's feet?

The larger the muscle to relax, the greater the amount of botulinum toxin needed. Therefore, men generally need a little more botulinum toxin. If the treatment is repeated, the muscle mass may decrease. Then a smaller amount of botulinum toxin may be sufficient to achieve the desired result. The following dosages per side are recommended for the treatment of crow's feet: Dysport®/Azzalure® 10-30 E, Botox®/Vistabel® 4-12 E, and Xeomin®/Bocouture® 4-12 E.

Can a Botox treatment for crow's feet be combined with other procedures?


The combination of Microneedling, PRP and Botox is particularly beneficial for the treatment of sun-damaged skin. The elasticity of the skin can be positively influenced by microneedling treatment and plasma therapy. Deeper skin wrinkles can be smoothed with a hyaluronic injection (filler) or a nanofat treatment.

How much does it cost to remove the crow's feet?

The invoicing of a Botox treatment is transparent and comprehensible according to the scale of charges for doctors. A consultation fee is charged for the first anamnesis interview, the examination, the preparation of a treatment plan and the consultation. The prices of the consultation and the treatment can be found on our costs page.

Before after after pictures of a treatment of crow's feet.

The law forbids the publication of images on the Internet. We will be happy to show you pictures during the consultation to show you the possibilities and limitations of a Botox treatment.

Why a treatment of the crow's feet in the CenterPlast Saarbrücken?

The injection technique and a certain amount of experience are important for the success of a treatment. However, botulinum toxin treatment has its limits. Only those who have a broad and profound knowledge in the field of aesthetic facial surgery can give you competent advice. A more experienced specialist in plastic and aesthetic surgery will not deprive you of an alternative and possibly more effective method. The plastic surgeons at CenterPlast are experts in a wide range of treatments and can therefore inform you about the advantages and disadvantages of each treatment method.

Dr. Santos Stahl and Privatdozent Dr. Stahl strive for a natural appearance that suits your inner condition. CenterPlast offers minimally invasive and state-of-the-art treatment methods.

A Botox treatment requires a detailed knowledge of the facial anatomy. Dr. Santos Stahl holds Brazilian, German and European qualifications in plastic and aesthetic surgery. She specialized for four years in the field of facial surgery in Stuttgart and another year in the field of ear surgery in Paris. Later, she perfected her techniques with the most influential plastic surgeons in Dallas, Oakland and Salt Lake City - thanks to a scholarship from the largest professional association of plastic surgeons in Germany (VDÄPC).

Every doctor can call himself "Cosmetic Surgeon", "Plastic Surgeon" or "Aesthetic Surgeon". The plastic and aesthetic surgeons of CenterPlast have a long and excellent education. The anti-aging industry makes many promises. Our recommendations are fact-based. The CenterPlast physicians have conducted many high-quality and independent scientific studies and are currently conducting various clinical trials.

Dr. Santos Stahl and Privatdozent Dr. Stahl attach great importance to safety and quality. We are happy to advise you individually and personally.

Field reports on the treatment of crow's feet in the CenterPlast Saarbrücken.

We systematically examine and compare the appearance, well-being and satisfaction of our patients after surgery. This includes not only uniform photo documentation, but also satisfaction with your appearance. At the same time, we also systematically check the possible influence of the procedure on the perceived self-confidence and attractiveness. We encourage our patients to rate us on Jameda and Google. Many patients are willing to share their experience with other patients to help them make the right decision. During the consultation we are happy to put you in touch with these patients.

Author's statement

Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.


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Your Centerplast team around PD Dr. Stéphane Stahl and dr. Adelana Santos Stahl is happy to advise you.

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