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Filed under: Crow's Feet,Laser Resurfacing — Dr. Andrew Campbell @ 5:45 pm

Question: Is laser resurfacing effective in treating crow’s feet? Is this area too sensitive for treatment?

Answer: Laser resurfacing can definitely be quite effective at treating crow’s feet, but I have found that in most cases the crow’s feet try to recur to some degree after the healing process has occurred. That is why in many of my patients, I will go ahead and treat the crow’s feet with Botox before and after their laser resurfacing so that the skin will heal as wrinkle free as possible. I then usually recommend that patients consider continued Botox in the future so that they can minimize any recurrence of the wrinkling in that area, but the laser resurfacing itself is quite effective at getting rid of deep lines and wrinkles in the crow’s feet area.


Filed under: Botox,Crow's Feet — Dr. Andrew Campbell @ 8:30 am

Question: I have been getting Botox injected into my crow’s feet for the past 2 years. I am thinking about stopping because it is too expensive. Will my wrinkles end up looking worse than before once I stop the injections?

Answer: Your wrinkles will not look worse than before just because you stopped your Botox treatments and in fact your Botox has really essentially preserved the skin from becoming overly wrinkly by allowing relaxation of the muscle that has been contributing to the crow’s feet during the time that you have been getting your Botox injections.  The wrinkles, however, will start to come back when the muscle function returns as the Botox wears off, but this should in no way make you worse off than you were before.



Question: Can a chemical peel be used to treat crow’s feet or is this too sensitive of an area to treat?

Answer: A chemical peel can definitely be used to treat crow’s feet. It really just depends on the type of a problem we have in the crow’s feet as well as what type of skin the patient has and their tolerance for any downtime. In many patients, the crow’s feet area really requires the use of Botox for adequate treatment and yet for many of those patients this does not adequately completely treat this area and, therefore, some sort of a skin resurfacing procedure, such as a chemical or laser peel, needs to be performed to give them the result that they desire.



Question: Is laser resurfacing effective in treating crow’s feet? Is this area too sensitive for treatment?

Answer: Depending on the individual, laser resurfacing can definitely be very effective in treating the crow’s feet as long as the patient has crow’s feet when they are not smiling. The laser can essentially allow for complete rejuvenation of the skin in that area, and I will frequently recommend that patients get regular Botox injections into that area to help prevent these lines from recurring.


Filed under: Crow's Feet,Eyes + Eyelids — Dr. Andrew Campbell @ 10:50 am

Question: I have creases and small wrinkles below my eyes. Do laser treatments work on the thin skin beneath the eyes? I have permanent crow’s feet that I would like removed at the same time if possible.

Answer: Yes, laser treatments can definitely work on the thin skin of the lower eyelid, but obviously great care has to be taken so that we get the result we want without any complications. Ultimately, you want to see an experienced surgeon that can perform laser resurfacing deep enough to create a significant amount of wrinkle reduction and yet not create any complications such as scarring or pulling of the lower eyelid. Other options, if you have a significant amount of excess skin, would be to pinch the lower excess skin away and place sutures similar to what is performed in an upper eyelid blepharoplasty. The sutures are removed in 3 days and the scar is extremely inconspicuous and is usually less obvious than the wrinkle that had been present in that location. Frequently a combination of the lower lid skin pinch and laser resurfacing is performed with or without a lower lid blepharoplasty.


Filed under: Botox / Dysport,Crow's Feet,Microdermabrasion — Dr. Andrew Campbell @ 5:15 pm

Question: I have very fine lines at the corners of my eyes. Is this something that microdermabrasion can treat? Is it safe so close to the eyes?

Answer: Microdermabrasion may be able to improve those lines slightly, but I really do not consider microdermabrasion a very effective way to treat wrinkles. Otherwise, microdermabrasion is exceptionally safe, even in and around the eye area when a crystal-free microdermabrasion is performed. Otherwise, I would recommend consideration of Botox for the crow’s feet.


Filed under: Crow's Feet — admin @ 4:27 pm

Question: Since I have entered my 50s, I have gotten very bad crow’s feet, which makes me feel very self-conscious. I would like to get a dermal filler to fix this that is proven to be effective on crow’s feet specifically. Which injectable filler is recommended for filling in crow’s feet?

Answer: There actually is no injectable filler at this time that is recommended for filling in crow’s feet, as no injectable filler has ever been given an FDA indication for crow’s feet wrinkles. With that said, I have certainly performed injections of crow’s feet with hyaluronic acid fillers, using them in a way which we call off label, which means that they are an FDA approved product, but we are not using them in the area that they are FDA approved for. Ultimately, it would be very wise to seek out an experienced injector so that these issues can be discussed before you end up having an injection that you don’t desire. Frequently, the crow’s feet area is much better treated with Botox than an injectable filler, but there certainly are circumstances where I feel patients are better served with the injection of a hyaluronic acid filler, such as Juvederm Ultra or Restylane. These specific patients typically have very little activity in the lateral orbicularis oculi muscle, which is the muscle that causes some of the crow’s feet. If they have very little activity, then Botox will not be very effective, and these are the patients that I will then recommend consideration of a hyaluronic acid filler.


Filed under: Crow's Feet — Dr. Andrew Campbell @ 11:21 am

Question: I am 53 years old and would like to know which procedure is the best for crow’s feet and several age spots. I have been learning about microdermabrasion and laser skin resurfacing. Which one provides the best results? Which one is cheaper? Which one has a shorter recovery period?

Answer: As far as treatment options go for crow’s feet, there are several. One of the most common ways to treat the crow’s feet is through the use of Botox which allows the muscle that causes the crow’s feet to relax. Unfortunately, this is typically not a fully adequate way to treat the crow’s feet due to the fact that some of these lines form due to the cheek elevation as we smile and this is certainly something that we do not want to relax or affect with Botox. Another option for the crow’s feet would be a brow lift in patients with some low-set brows. By lifting the brows, we essentially stretch out the crow’s feet area and they are greatly improved. Third option, as you had mentioned would be laser resurfacing, but microdermabrasion in my opinion really will do very little for actual crow’s feet. Certainly when comparing microdermabrasion and laser resurfacing, microdermabrasion is going to be much less expensive, it will have no downtime as opposed to at least several days of downtime with a laser resurfacing, but the downside of the microdermabrasion is that it will do very little, if any, improvement in actual crow’s feet wrinkles. Frequently I will combine various modalities to give the patient the best result possible. In fact, frequently I will not only perform a brow lift with a laser resurfacing, but then also treat the patient with Botox for the first 6 months after the laser resurfacing to try to prevent some of these crow’s feet from returning. This in my opinion seems to be my personal gold-standard for facial rejuvenation I this region.


Filed under: Chemical Peel,Crow's Feet — Dr. Andrew Campbell @ 5:32 pm

Question:  After 10 years of teaching high school, needless to say, I have developed quite a few wrinkles.  I cannot quite afford surgery but less invasive options might work on my budget.  Will a chemical peel soften my well-earned wrinkles after a few treatments? 

Answer:  Yes, there are certainly chemical or laser peels that can be used to soften wrinkles and improve the texture and coloration of the facial skin.  At Quintessa Medical Spa, we have various treatment options from chemical peels to more sophisticated lasers, such as the ProFractional laser by Sciton that lasers small channels in the skin that create new collagen, wrinkle reduction and, overall, improve the texture and discoloration of the skin.  Oftentimes, we combine various treatment modalities in one session in order to maximize the effectiveness of the treatment.  One of these is where we combine broadband light with ProFractional laser resurfacing as well as a Micro Laser Peel, and we call this the North Shore Reveal.  It can be extraordinarily effective at improving fine lines and wrinkles, skin discolorations, and rough surface texture.  It has approximately two to three days of some mild downtime but the result is well worth the effort and cost.  For significant skin problems, we will recommend a series of three treatments spaced four to eight weeks apart.


Filed under: Botox / Dysport,Crow's Feet — Dr. Andrew Campbell @ 11:04 am

Most of the time it is virtually impossible to completely rid a patient of their crow’s feet lines due to the fact that there are really 2 different components as to why the patient has the crow’s feet lines in the first place. One of these components is the activity of the orbicularis oculi muscle that can contract and create these lines. The second is the elevation of the cheek that occurs when we smile. These 2 in most patients occur simultaneously and we can treat the orbicularis oculi muscle with Botox and get this muscle to relax and have a significant improvement in the crow’s feet lines. We do not, however, want to relax the muscle that enables the person to smile and raise the cheek and thus they will still have some folding of the skin to the side of the eye when they smile and elevate their cheek. So, in most patients, treatment of the crow’s feet area with Botox only softens these lines, but does not completely get rid of them.


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