Crow’s feet treatment at Core Aesthetics targets the lateral fibres of the orbicularis oculi at conservative doses, with careful spacing from the lateral canthus to avoid lagophthalmos or lateral lid laxity. Two week review is standard. Results vary between individuals.
The lines that fan from the outer corner of the eye when you smile are among the first expression lines most people notice. They appear early, sometimes in the late twenties, because the muscle that produces them is one of the most active in the face. Every blink, every laugh, every squint into bright sun fires it. Decades of that activity leaves a fine, characteristic radiating pattern that people refer to as crow’s feet, and that anatomists call lateral canthal rhytids.
Crow’s feet are not the same problem as forehead or glabellar lines. They are produced by a circular muscle that wraps the eye and closes the lid, not by a directional pulling muscle. Their appearance is usually welcomed during a smile and disliked at rest. They sit beside one of the most delicate areas in the face, where small dose errors produce noticeable side effects: a flattened smile, a heaviness under the eye, or in unusual cases temporary closure problems. The clinical answer to crow’s feet is not maximum effect. It is enough effect to soften the resting impression, with conservative dosing well clear of structures that should not be treated.
The anatomy of the lateral orbicularis
The orbicularis oculi is a thin, broad sheet of muscle that wraps the eye in a circle. Anatomists describe it in three parts. The orbital portion forms the outer ring of the muscle and crosses the bony rim around the eye; this is the portion that contracts hard during forced eye closure and during a deep smile, and it is the part that produces visible crow’s feet. The palpebral portion sits within the eyelids themselves, divided into a preseptal section behind the lid skin and a pretarsal section against the tarsal plate; this part performs ordinary blinking and gentle eyelid closure. There is also a small lacrimal part involved in tear drainage. Anti-wrinkle treatment for crow’s feet is targeted at the lateral fibres of the orbital portion only. The palpebral portion is deliberately left untreated.
Where the contracting fibres meet the skin, the contraction radiates outward like the spokes of a wheel from a hub. Each fold the contraction produces is repeated millions of times across a lifetime. By the late thirties or early forties, the skin in this area, which is some of the thinnest skin on the face, has developed mechanical creasing that does not fully relax even when the muscle is at rest.
What Anti-wrinkle treatment does at the cellular level
Anti-wrinkle injection uses a prescription form of botulinum toxin type A, delivered in small calibrated doses to specific points within the lateral orbital fibres. The medication does not act on muscle directly. It works at the synapse between the nerve and the muscle, where contraction is signalled by acetylcholine release. A protein on the inside of the nerve terminal, SNAP-25, helps acetylcholine vesicles fuse with the membrane and release their contents. Botulinum toxin enters the nerve terminal by endocytosis, cleaves SNAP-25 enzymatically, and prevents that fusion. Without acetylcholine release, the muscle does not receive the contraction signal, and the skin above it folds less.
The effect is local, dose dependent and temporary. Onset begins at three to five days, with the settled result generally apparent at the two week review. Over the following months, the original nerve terminals recover the ability to release acetylcholine, helped by the temporary growth of small axonal sprouts that form new synaptic contacts. As the original terminal returns to function, the sprouts retract. For most clients the settled effect on crow’s feet lasts three to four months, sometimes a touch longer in clients with low baseline activity, sometimes shorter in clients whose orbicularis is exceptionally active.
Why the eye area requires more care than other regions
Two structural features make the periorbital area technically demanding. The first is proximity to muscles that should not be treated. The zygomaticus major, which lifts the corner of the mouth into a smile, runs underneath the lateral cheek a short distance below the lateral canthus. Diffusion of medication into that muscle produces an asymmetric or weakened smile that is disliked far more than the original lines. The second is the palpebral portion of the orbicularis itself, which performs blinking and lid closure. If the medication diffuses into the palpebral portion, transient lagophthalmos can result, in which the lid does not fully close during sleep. Both complications are uncommon at conservative doses with appropriate placement, and both are why injection points are kept at least 15 to 20 millimetres from the lateral canthus, on a vertical line just lateral to the bony orbital rim.
A third factor is the patient’s own smile dynamic. Crow’s feet during a deep smile are part of an honest, animate face. Treatment that flattens them entirely changes the character of the smile, and most clients who experience this once never request it again. Conservative dosing aims at softening the resting and low effort lines, while preserving the strong lines of a full laugh. The latter are not the problem the patient came in with.
When crow’s feet treatment is not the right option
Crow’s feet are not always best treated with injectable medication. Where the visible lines are predominantly dermal, etched into thin, sun damaged skin, anti-wrinkle treatment will soften the muscular contribution but will leave a substantial portion of the visible lines unchanged. In this group, the better discussion at consultation is about skin quality (sun protection, retinoids, in some cases procedural skin treatments managed elsewhere) rather than about a higher dose of the same injectable. Over-treating in this scenario produces a flattened smile without removing the underlying skin damage.
Other reasons to defer or decline include pregnancy, breastfeeding, active eye area infection, recent eye surgery (within six months unless otherwise advised by the treating ophthalmologist), significant dry eye disease that has not been reviewed by an optometrist or ophthalmologist, and known sensitivity or contraindication to botulinum toxin. The 2025 AHPRA guidelines for nonsurgical cosmetic procedures, in effect since 2 September 2025, formalise the practitioner’s obligation to consider whether the procedure is in the patient’s best interest, including circumstances where it is not.
A typical consultation presentation
A patient in her early forties presents asking specifically about crow’s feet, which she has begun noticing in close up photographs at family events. She has had anti-wrinkle treatment in the forehead and glabella elsewhere and was satisfied with those results. She has no history of eye surgery and no current dry eye symptoms. She is mildly anxious about a flat or unnatural smile, which she has seen on a relative.
At consultation Corey assesses the orbicularis at rest, during a gentle smile, during a forced smile, and during squinting. The dynamic lines are clear during all three. The resting lines are mild, mostly visible in the lateral aspect. There is no significant skin laxity below the lower lid. The recommendation is conservative bilateral treatment of the lateral orbital fibres, with three points each side at standard distances from the lateral canthus. The patient is reassured that the strong dynamic lines of a full laugh will be partially softened but not eliminated, and that the goal is the resting impression. A two week review is booked. Treatment is not performed on the day of consultation.
Conservative dosing and the two week review
Crow’s feet are treated at low starting doses, typically two to four units per point with two to three points each side, depending on the size and activity of the muscle and the response to prior treatment if applicable. A first cycle that lands somewhat under treated is the right error to make in this area. Botulinum toxin can always be added at the two week review when the response has settled. It cannot be removed once placed, and the consequences of over-treatment around the eye are visible enough that conservative starting is the universal default.
The two week review is photographed in repose, during gentle smile and during forced smile. Brow position, lid position and smile dynamic are compared to the consultation baseline. Any small adjustment, including a small additional dose where placement did not fully cover a stubborn fibre or where one side has responded less, is made then. The session is short and is included in the cost of the original treatment. Subsequent treatment intervals are planned individually rather than scheduled at a fixed cadence.
What results can and cannot do
Anti-wrinkle treatment is effective at softening the dynamic lines that appear during low- to mid effort expression. The visible difference is most striking during conversation, ordinary smiling and squinting in moderate light. With consistent treatment over several cycles, the lines visible at rest also tend to soften slightly, because the skin has been given periods of reduced mechanical folding to recover. This is not the same as removal, and it does not happen at the first appointment. It is a gradual change visible at the six- to twelve month mark.
What treatment cannot do is restore lost volume in the cheek or upper midface, change the texture or thickness of thin under-eye skin, lift heavy lower lids, or remove lines that are predominantly dermal in origin. It also cannot make a smile look exactly the same as before treatment. A small change in smile dynamic is part of the deal, and conservative dosing keeps that change within the territory most patients describe as refreshed but still me.
Safety, complications and clinical oversight
Crow’s feet treatment is among the most studied applications of botulinum toxin type A in clinical aesthetics. Serious adverse events are rare when treatment is performed by a registered practitioner working within a clinical framework. The most common short term effects are pinpoint bruising at injection sites, mild redness, and transient tenderness. Bruising is somewhat more common in the periorbital area than elsewhere on the face because the skin is thin and the local vasculature is dense; conservative needle placement and avoidance of visible vessels minimises this but does not eliminate it.
Complications specific to the eye area are uncommon at conservative doses but include lateral lid laxity (a softening of the muscle support that holds the lower lid against the eye), transient lagophthalmos (incomplete lid closure during sleep), and asymmetric or weakened smile if diffusion reaches zygomaticus. Most resolve over the duration of the medication’s effect; in unusual cases ophthalmological review is appropriate. At Core Aesthetics, every treated patient receives a written aftercare summary, a direct contact for post treatment concerns, and a booked review.
long term planning and treatment intervals
Crow’s feet treatment is rarely a single appointment. Most clients who continue treatment find a rhythm of three to four months. Some find that intervals lengthen over years of consistent treatment, as the resting tone of the orbicularis settles and the dermis recovers from years of folding. Others maintain a steady cadence. Neither pattern is preferable; both reflect normal individual variation. Repeat treatment is reviewed at each visit and adjusted to the actual settled response, not to a calendar.
Over a multi year horizon, the most informative comparison is photographic. The day to day mirror is not a useful instrument for noticing the slow softening of dermal etching that happens when the underlying muscle is treated consistently. The consultation photograph and the annual review photograph, side by side, frequently show a change that the patient had stopped noticing.
Photography, documentation and the case for review
Photographic documentation is part of the clinical infrastructure of consistent injectable treatment. At consultation the face is photographed in repose, during a gentle smile and during a forced smile. The same images are repeated at the two week review and at every subsequent visit. The two view plus rest set is particularly useful around the eye, where the rest condition tells one story and the smile condition tells another, and where treatment outcomes are best evaluated against both.
Photographs are stored under the same medical record framework as the rest of the consultation documentation. They are not used for marketing or shared outside the treatment record without separate, specific consent for that use. Australian regulation under the Therapeutic Goods Advertising Code prohibits the use of patient endorsement imagery for cosmetic procedures involving prescription medicines, and the photographic process at Core Aesthetics is structured around clinical comparison rather than promotion. The most useful comparison is rarely the immediate after; it is the six- and twelve month image, when the cumulative effect of treatment is most visible.
After treatment: aftercare and what to watch for
The injection itself is brief, ordinarily a few minutes after the assessment is complete. Most clients leave the clinic immediately afterwards and resume usual activity. Conservative aftercare guidance applies for the rest of the day: avoid lying flat for several hours, avoid vigorous exercise that elevates heart rate sharply, avoid massaging the treated area, and avoid heat exposure. The reasoning is to allow the medication to bind locally rather than diffusing towards the palpebral orbicularis or zygomaticus. After the first day, ordinary activity resumes without restriction.
Bruising at injection points is the most common short term effect and resolves over a few days. A small minority of clients experience a brief headache or a feeling of tightness through the temple area. Concerns that warrant prompt contact include persistent eyelid drooping, marked smile asymmetry, lid closure problems, or any signs of skin infection at an injection point. The aftercare summary includes a direct contact for these situations and the booked review date.
The consultation at Core Aesthetics
Corey Anderson, Registered Nurse, AHPRA NMW0001047575, is the sole treating practitioner at Core Aesthetics. Every client is seen by Corey personally for every appointment, from initial consultation through to ongoing review. His registration is publicly verifiable at coreaesthetics.com.au/verify.
The crow’s feet consultation covers how the orbicularis behaves at rest, during gentle smile, during forced smile and during squint; the relationship between dynamic and static lines; eye history (surgery, dryness, tear function); and the realistic outcome of treatment for the lines that are bothering you. A conservative first dose with a two week review is the structural standard. Treatment is not performed on the day of consultation as a default. Many consultations end with a treatment plan booked for a subsequent appointment, or with a recommendation to defer or to focus on skin quality first.
Serving Melbourne from Oakleigh
Core Aesthetics is at 12A Atherton Road, Oakleigh VIC 3166. The clinic serves clients seeking crow’s feet treatment from across Melbourne’s south east and inner suburbs. Open Tuesday to Saturday by appointment.
For related reading: anti-wrinkle treatment in Melbourne, forehead line treatment, frown line treatment, the C.O.R.E. Method and about Corey.
Further Reading on Periorbital Lines
For a clinical overview of the injectable treatment approach for periorbital lines, see our article: Crow\’s Feet Injectable Treatment Guide.
Is this for you?
Consider booking a consultation if
- You are noticing lines that fan from the outer corners of the eyes when you smile or squint and want to understand what anti-wrinkle treatment can and cannot do
- You are eighteen or older, in general good health, and not currently pregnant or breastfeeding
- You want an individual consultation, a written plan and a planned two week review rather than a same day fixed dose
- You are open to being told that the visible problem is partly dermal and that skin quality, not a higher dose, is the better next step
This may not be for you if
- You are pregnant, trying to conceive, or breastfeeding
- You have an active infection or inflamed skin around the eye area
- You have a neuromuscular condition for which botulinum toxin is contraindicated
- You have a history of recent eye surgery or significant dry eye that has not been reviewed by an optometrist or ophthalmologist
- You are seeking a flat, lineless eye area regardless of starting anatomy or skin condition
Suitability is confirmed at consultation. This list is general guidance, not a substitute for clinical assessment.
Frequently asked questions
What anatomy produces crow’s feet?
Crow’s feet are produced by the lateral fibres of the orbicularis oculi, the circular muscle that wraps the eye and closes the lid. The orbital portion of the muscle contracts hard during smiling, squinting and forced eye closure, and the contraction radiates outward like the spokes of a wheel. The palpebral portion, which performs blinking, is deliberately left untreated.
Why do you watch the smile during the consultation?
The shape and depth of the lines varies with the dynamic of an individual smile. Some smiles fire the lateral orbicularis hard and produce strong fanning lines; others fire it softly. The treatment plan reflects what the muscle is actually doing on your face, not a fixed protocol. Watching the smile also identifies the position of zygomaticus, which is deliberately avoided to prevent smile flattening.
How does the injection actually soften the line?
The medication blocks acetylcholine release at the nerve to muscle junction by cleaving a synaptic protein called SNAP-25. The targeted lateral fibres do not receive the contraction signal, so the skin above them folds less. The effect develops over three to five days, settles at two weeks, and lasts in the region of three to four months.
How long do crow’s feet results typically last?
Most clients see settled effect for three to four months in the periorbital area. Individual metabolism, baseline muscle activity and dose all influence duration. The interval is reviewed at follow up rather than scheduled in advance, and tends to lengthen slightly in clients who have been treated consistently over years. Results vary between individuals.
Will my smile still look natural after treatment?
A successful conservative result preserves the natural character of the smile. The strong fanning lines of a full laugh are partially softened but not eliminated. The change is most visible in the resting and low effort lines, which is what most patients are asking to address. A flattened or unnatural smile is the result of over-treatment or treatment too close to zygomaticus, both of which conservative dosing and standard injection point spacing are structured to avoid.
Is crow’s feet treatment painful?
The injection itself is brief and uses a fine needle. Most clients describe a small sting at each injection point that lasts a second or two. The skin in the periorbital area is sensitive and bruising is somewhat more common here than on the forehead, although it usually resolves over a few days. Anaesthetic cream can be used at consultation request but is not generally needed for this area.
When is crow’s feet treatment not appropriate?
When the visible lines are predominantly dermal etching in thin sun damaged skin (anti-wrinkle treatment will only address the muscular contribution), when there is significant unmanaged dry eye or recent eye surgery, in pregnancy or breastfeeding, in active periorbital infection, or when realistic expectation cannot be aligned at consultation. In each of these cases the consultation discusses whether to defer, decline, or focus on a different intervention.
Can crow’s feet treatment cause eye closure problems?
Lagophthalmos, where the lid does not fully close during sleep, is a recognised but uncommon complication when medication diffuses into the palpebral portion of the orbicularis. Standard injection point spacing of at least 15 to 20 millimetres from the lateral canthus, conservative dosing, and avoidance of immediate post treatment massage of the area substantially reduce this risk. Where it does occur it is transient and resolves over the duration of the medication’s effect.