Summary
Cosmetic botulinum toxin softens the dynamic lines caused by repeated muscle contraction, especially around the eyes (crow’s feet), between the eyebrows (frown lines) and across the forehead. As an oculoplastic surgeon I treat the periocular and forehead region as part of the broader eyelid practice, with the same precision used for ptosis or blepharoplasty surgery.
For functional treatment of blepharospasm or hemifacial spasm, see functional botulinum toxin.
Who is this for?
Patients I commonly see for aesthetic treatment:
- visible crow’s feet at the side of the eyes,
- a vertical frown line between the eyebrows (‘elevens’),
- forehead lines that persist at rest,
- a subtle, non-surgical brow lift,
- a small downturn at the outer corner of the eye.
Patients with visible skin excess or fat prolapse usually need surgical management (upper blepharoplasty, lower blepharoplasty) instead of, or in addition to, botulinum toxin.
What the procedure involves
A consultation in clinic, with a thorough discussion of your goals and the realistic limits of what botulinum toxin can achieve. Treatment takes around 10 minutes - a series of tiny injections at carefully chosen anatomical points.
I use the lowest effective dose for a natural-looking result and review the response at 2 weeks, with adjustment as needed.
Recovery and what to expect
- Effect begins at 3-7 days; peak effect at 2 weeks.
- Avoid rubbing the area or lying flat for 4 hours after treatment.
- Mild bruising at the injection sites can occur.
- Effect lasts 3-4 months; repeat treatment as desired.
Risks and alternatives
Risks are uncommon and include temporary bruising, asymmetry, mild eyelid droop or brow heaviness - all of which resolve as the toxin wears off. Allergy and double vision are extremely rare.
Alternatives include skincare, dermal fillers (for lines that are present at rest), and surgical procedures for marked skin or fat changes.