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Botox
Potential problem with Botox in crows feet. Have I seen the worst of it (day 4 post op) and how long will it last?
As others have mentioned, it takes up to 2 weeks after initial Botox injection to see the maximum results so likely you will notice more paralysis of the crow's feet for the next few days. The muscle around the eye is a circular sphincter muscle called orbicularis oculi. Botox injected to the outer corners of this muscle will minimize the appearance of crow's feet but does not paralyze the other parts of the muscle so sometimes patients may notice hyperactivity of the lower part of the muscle as a compensatory mechanism. This bunching should soften with time as the Botox wears off but if it's very bothersome, you can talk to your injector about placing a very small dose of Botox at the undereye area to soften the appearance of the lines under the eyes when smiling. Botox in this area is considered off-label and it is recommended to see an experienced board-certified clinician.
Clinical Context
The bunching you're noticing is usually a normal compensatory response from the untreated lower part of the orbicularis oculi muscle, not a sign that anything went wrong. It tends to soften over one to two weeks as the treated area settles. Taking a photo now and comparing it in two weeks can help show how much is simply the toxin still taking effect. If bunching remains bothersome after that, a small off-label touch-up under the eye is worth discussing with your injector.
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