Onabotulinumtoxin A (BOTOX Cosmetic), incobotulinumtoxin A (XEOMIN), abobotulinumtoxin A (Dysport) injections may be used to weaken the muscles that cause facial wrinkles, frown lines, and "crow's feet," toning down these features. Many patients choose botulinum toxin injections because they are quick and easy.

The procedure takes approximately 30 minutes to perform. First, the area is cleaned and a local anesthetic may be administered. Then, the botulinum toxin is injected directly into the muscle that controls the targeted facial line. Patients are advised not to lie down for 2 to 4 hours following the procedure and to avoid taking products that contain aspirin, as they increase the risk for bruising.

Side effects, which usually resolve on their own, include headache, pain, and flu-like symptoms. When used to treat moderate-to-severe crow's feet, eyelid edema (swelling) may occur. Drooping eyelids, another possible risk, can be treated using prescription medications.

Following botulinum toxin injections, noticeable improvement usually occurs in about 10 days. In approximately 3 months (sometimes longer), the effects of the procedure begin to wear off, and the patient requires follow-up injections.

Because botulinum toxin is an egg-based substance, patients who have egg allergies should not undergo the injections. Treatment is also not advised for women who are pregnant.

Publication Review By: the Editorial Staff at

Published: 27 Jul 2006

Last Modified: 19 Nov 2014