Still got Crow’s Feet After Botox? Understanding Skin Laxity
If you’ve had Botox for crow’s feet but still notice some lines appearing when you smile, this may be due to ‘skin bunching’. This is a common occurrence and is not due to the fact the Botox ‘didn’t work’, it happens because Botox only targets the muscles around the eyes, not the ones in the cheeks.
What Is Skin Bunching?
Skin bunching refers to the small folds or creases in the skin that appear when we smile, especially along the cheekbones and the sides of the face. It’s different from dynamic Crows feet wrinkles (which are caused by the eye muscle contracting), instead it happens due to skin thinning, laxity and loss of volume.
Why Does Skin Bunching Happen?
When Botox is injected into the orbicularis oculi (the muscle around the eye responsible for crow’s feet - the grey circular muscle in the image below), it relaxes the contraction that causes those fine lines at the side of the eye. However, Botox doesn’t treat the cheek muscles (the diagonal pink muscles in the image below, attached from the mouth corner to the cheekbones) —and when you smile, your cheek muscles contract, pushing the skin upward. If the skin is firm and elastic, it stays smooth. But as we age we lose volume, plus the skin gets thinner, loses collagen and elasticity, meaning it no longer stays firm and supported. Instead, it folds and bunches when we smile.
A Simple Analogy: Cardboard vs. Tissue Paper
Think of youthful skin like a piece of cardboard—if you try to crush it between your hands, it doesn’t crumple easily. Now, think of aged skin like tissue paper—when you press it together, it crumples into fine wrinkles. The thinner and less elastic the skin, the more it will bunch and wrinkle when moved by the muscles beneath it.
Can We Prevent or Treat Skin Bunching?
While Botox can’t stop the cheek muscles from moving, there are other ways to help reduce skin bunching and improve skin thickness & quality. A combination of the following approaches works best:
✔ Dermal Fillers – Restore lost volume and support the skin, reducing the appearance of folds and creases.
✔ Microneedling & Polynucleotides – Stimulate collagen and elastin production to strengthen and rejuvenate the skin.
✔ Skin Boosters & Profhilo – Hydrate and plump the skin, increasing its firmness so it doesn’t crumple as easily.
✔ Medical-Grade Skincare – Retinol, peptides, and growth factors help build collagen and strengthen the skin over time.
✔ Chemical Peels – Encourage cell turnover and improve overall skin texture and thickness.
Final Thoughts
If you’ve noticed skin bunching after Botox, don’t worry—it’s a normal part of aging and facial movement. While Botox smooths expression lines, improving skin quality is the key to reducing bunching. If you’re unsure how to best treat your skin, book a consultation at our aesthetics & skin clinic in Portadown, Northern Ireland, and we’ll create a tailored plan to keep your skin looking smooth, firm and youthful!
