Crow's Feet

Whether they disappear when your face is completely still is the whole answer: lines that go are dynamic, lines that stay are static. Do the check in front of a mirror with no smiling and no squinting, and give your face a few seconds to settle first, because a face that has just been talking or reading a screen is rarely as relaxed as it feels. Bright overhead light exaggerates a shallow line and flat light hides one, so a window in daylight gives a truer reading than a bathroom mirror at night. The test is the one dermatology uses to sort facial lines: a line that changes with muscle movement is dynamic, and a line that does not change is static. One face can carry both kinds at once, with some lines going when it settles and others staying. The distinction decides what treatment makes sense, which is why the check is worth doing. Botox relaxes the muscle that folds the skin, so it works directly on a dynamic line. It cannot flatten a crease that is already part of the structure of the skin, and for that the treatment has to work on the skin itself, which microneedling does. Say which lines you mean at the consultation, and whether they were there before you smiled.

Correctly dosed and correctly placed, no, because the muscles that lift your cheek and move your mouth are not the ones being treated. The flattened or asymmetric smile people have seen comes from over-treatment, or from the toxin spreading out of the small area of orbicularis oculi that makes the crease and reaching the muscles that do the smiling. DermNet puts unintended weakness of nearby muscles at fewer than one treatment in ten across all uses of botulinum toxin A, and it resolves as the effect wears off rather than lasting. Placement for this area is set out in the Health Canada product monograph: the injections sit at least a centimetre outside the bony orbit, lateral to the orbital rim where the lines show on a forced smile, and not inside the vertical line through the outer corner of the eye. Those limits exist to keep the toxin away from the muscles that move the eye and the mouth, and staying inside them is what keeps the rest of the face working as it did. What a correct treatment gives you is the crease softening or going on a smile or a squint, with the smile itself unchanged: how wide it is, how the cheek lifts, how the mouth moves. If a previous treatment somewhere else left you with a stiffer smile than you wanted, say so at the consultation, because dose and placement can both be changed.

A static line needs treatment that works on the skin's own structure, because the muscle is no longer the whole cause of it. Microneedling punctures the skin to a set depth with fine needles, and that controlled injury starts a cascade of growth factors which produces new collagen, elastin and small blood vessels, thickening the skin and improving its texture and firmness. It is one of the few resurfacing treatments that suits the skin near the eye, where chemical peels and laser resurfacing are not suitable, and the epidermis stays intact, so the same area can be treated again. Sessions are spaced at least six weeks apart because new collagen takes that long to form, which is also why the change builds over a course rather than appearing in days the way Botox does. Intensif adds radiofrequency energy to the needling and works at a depth standard microneedling does not reach, which counts for more on a line that is well established. Botox still earns its place on a static line, because reducing how hard the skin folds from now on slows the line setting further, and the two run together for that reason: Botox for the muscle, microneedling or Intensif for the skin that is already creased. How many sessions make sense depends on how deep the crease has gone, which is a judgement made by looking at the line rather than from a description of it.

There is no age that is too early, and the honest version of the argument is narrower than the earlier the better. Relaxing the orbicularis oculi means the skin at the outer eye folds with less force and less often when you smile or squint, and skin that folds less often takes longer to set a crease into its own structure. That is a mechanism rather than a sales line, and it is the reason treating dynamic lines before they become static can slow the change. What it is not is a guarantee against ageing generally, or a promise that static lines will never form. Ultraviolet exposure, genetics, skin thickness and how strongly the muscle contracts all keep acting whatever you do about the muscle. Someone whose lines vanish completely at rest is in a different position from someone whose lines are partly set already, and it is reasonable for the two to decide differently. The more useful question than too early or too late is what your own lines are doing right now, dynamic, static, or a mix of the two, and that is what the consultation establishes by looking at your face moving and at rest. Starting later closes nothing off either. A static line has more treatment options than it has prevention options.

Cost depends on how much is used and on which treatments your own lines need, which is why a figure quoted before anyone has looked at your face would be a guess. For Botox, the number of units depends on how strongly the muscle folds the skin and how much softening you want; a lighter correction that leaves more movement uses less than a fuller one. A line that has set into the skin adds microneedling or Intensif, priced by the session and given as a course, so the plan for a static line costs more than the plan for a dynamic one. Someone with a few lines that disappear at rest is looking at something simpler than someone with a set crease and thinning skin across the outer eye. The complimentary consultation is where the dynamic-or-static question gets settled and where the plan and its cost are set out for your own face. The two treatments also keep different schedules. Botox wears off across three to four months and is given no more often than every three months, while microneedling sessions sit at least six weeks apart and the collagen a course builds does not wear off on the same clock. Over a year that difference matters more to what you spend than the price of any single appointment.