Lines at the outer eye come from smiling, which is why the aim is to soften them without taking the smile with them.
The fine lines fanning outwards from the corner of the eye come from the orbicularis oculi, the ring of muscle that closes the eye. It contracts every time you smile, squint or laugh, and the skin over it is the thinnest on the face, so it creases early and easily.
Treatment reduces the activity of the outer portion of that muscle so the skin folds less. Small amounts are used in a superficial plane, well away from the structures that move the eye itself.
At Dr Ellie Sateei’s London and Sevenoaks clinics these lines are deliberately softened rather than removed, because the muscle that creates them is also the muscle that makes a smile look genuine. Results vary between individuals.
Small amounts of botulinum toxin are placed superficially at points lateral to the eye, typically two or three per side, avoiding the muscles controlling eye movement and lid closure.
Two things determine the plan. The first is how much of the line is muscular and how much is skin quality: crepey, sun-damaged skin at the outer eye will still crease after the movement is reduced, and no amount of additional toxin changes that. Where skin quality is the dominant factor, polynucleotides or a skin booster does more than a larger dose would.
The second is the lower lid. Treating too low or too heavily can weaken lid support, which in some patients produces a hollow or a change in how the lower lid sits. Conservative placement and dose is how that is avoided.
Where lines persist on the lower lid at rest, or where the skin is thin and crepey, Dr Sateei will usually recommend addressing the skin rather than the muscle, and will say so rather than treating more.
It may suit you if you are looking to:
It is not suitable during pregnancy or breastfeeding, or with certain neuromuscular conditions. It is approached carefully where there is significant lower lid laxity, under-eye puffiness or very thin, crepey skin, and in those cases a skin quality treatment is often the better first step.
Treatment takes around 10 to 15 minutes. Very fine needles are used and numbing is generally not required. The skin here is thin and well supplied with small vessels, so pinpoint bruising is a little more common than elsewhere and settles within a few days.
Onset begins around day three to five, with the full effect at around two weeks, and new patients are reviewed then.
The effect typically lasts three to four months. Because dose is light in this area, duration is sometimes at the shorter end.
| Treatment | London | Sevenoaks |
|---|---|---|
| Anti-wrinkle injections | From £495 | From £295 |
| Polynucleotide eye rejuvenation, 1 session | From £450 | From £450 |
New patient consultation, £195 at both clinics. If you go ahead with treatment on the day of your appointment, this fee is deducted from the cost of your treatment.
Prices correct as published and subject to change.
“These lines come from smiling, which is worth remembering before deciding to remove them entirely. A face that creases at the outer eye when it laughs is a face that reads as warm. I soften them, I do not switch the mechanism off, and where the real issue is thin sun-damaged skin rather than muscle I will tell you that toxin is not the answer and offer you the one that is.”
Dr Ellie Sateei has over two decades of experience in dermatology and aesthetics.
Anti-wrinkle injections are from £495 in London. Your consultation is £195, deducted from treatment on the day.
Yes, that is the point of dosing lightly here. The muscle creating these lines is also what makes a smile read as genuine, so it is softened rather than switched off.
Typically three to four months, and sometimes at the shorter end because the dose used in this area is deliberately light.
Often because the skin itself is thin, crepey or sun-damaged, which creases regardless of movement. Where that is the dominant factor, polynucleotides or a skin booster does more than additional toxin.
Placing too low or too heavily can affect lid support in some patients, which is why conservative dose and careful placement are used and why the area is assessed for existing laxity first.
Pinpoint bruising is a little more common here than elsewhere, as the skin is thin and well supplied with small vessels. It usually settles within a few days.
Treatments often booked alongside fixing crow’s feet
Crow’s feet come from smiling, and the aim is to soften them without flattening the expression that creates them. If the lines at your outer eyes bother you, an assessment will establish how much is muscle and how much is skin, because those need different answers. Dr Ellie Sateei sees patients at her London clinics.
Our London clinic is located at 91a New Cavendish Street, London, W1W 6XF
We serve patients from London, Kent and the home counties as well as from all over the world. Our London clinic sits in the heart of Marylebone, within easy reach of the West End by tube, while our Sevenoaks clinic in Ightham is moments from the M25 and M26 for patients across Kent.
