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I Got Cheek Fillers and Now My Crow’s Feet Are Worse When I Smile

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How to Avoid Worse Crow's Feet After Cheek Fillers

Choosing the right injector, understanding your unique facial anatomy, and opting for a conservative approach with dermal fillers greatly reduce the chances of worsening crow's feet after cheek augmentation.

Imagine this: You've just had cheek fillers to restore youthful contours to your face. You're thrilled with the results...until you smile. Those pesky crow's feet seem deeper, more pronounced than ever. Has your quest for a refreshed appearance backfired?

Cheek fillers are a popular and minimally invasive way to combat signs of aging. By restoring lost volume in the midface, they can lift the cheeks, smooth out lines, and create a more youthful appearance. However, there's one potential side effect that can catch some patients off guard: worsened crow's feet.

Why Do Cheek Fillers Sometimes Worsen Crow’s Feet?

The relationship between cheek fillers and crow's feet lies in the complex interplay of facial anatomy and how fillers alter the supporting structures.

  • Facial Anatomy 101: The orbicularis oculi muscle encircles your eyes and is responsible for expressions like smiling and squinting. Over time, repeated contraction creates dynamic wrinkles – crow's feet. Cheekbones provide underlying support for the mid-face and, indirectly, the eye area.
  • The Filler Effect: When fillers add volume to the cheeks, they change this support system. The added weight and lift can sometimes stretch the skin over the orbicularis oculi muscle, making the crow's feet appear more prominent when you smile.

Is This a Common Side Effect, or Is It Dependent on Individual Facial Structure?

A Woman Getting Cheek Filler Treatment

Not everyone will experience worsened crow's feet after cheek fillers. Several factors influence your individual risk:

  • Pre-existing wrinkles: If you had deeper crow's feet before fillers, they might become more noticeable afterward.
  • Facial structure: Those with naturally higher cheekbones and less volume in the midface may be more susceptible to this issue.
  • Age and Skin Elasticity: As we age, the skin loses elasticity, making it more prone to stretching rather than smoothly accommodating added volume.

What Filler Types and Placement Techniques Increase the Chance of Worsened Crow’s Feet?

Filler choices and how your injector places the product play a big role:

  • Thicker fillers: Heavier, more viscous fillers are designed for significant volume restoration in the cheeks and are more likely to stretch the skin in the eye area.
  • Deep placement: If filler is injected too deeply, close to the bone, it creates a strong lifting effect that can indirectly exaggerate crow's feet.
  • Excessive volume: Using too much filler in the cheekbones can lead to an overfilled look that stretches the skin unnaturally.

Can the Worsened Crow’s Feet Be Corrected, and How?

Don't panic! There are ways to improve worsened crow's feet:

  • Strategic Botox: Injections of Botox (or similar neuromodulators) can temporarily relax the orbicularis oculi muscle, smoothing out dynamic wrinkles.
  • Filler Dissolving: In some cases, partially dissolving the cheek filler with hyaluronidase can decrease the stretching effect and improve crow's feet.
  • Alternative Filler Strategy: Your injector might recommend a softer filler, placed more superficially in the cheeks to gently recontour the area without excessive lift.

What Should Someone Do if They Experience This After Getting Cheek Fillers?

The most important step is open communication with your injector. Schedule a follow-up appointment; they can assess the situation and recommend the best course of action.

How Can This Issue Be Prevented in the First Place?

Prevention is always better than correction. Here's how to minimize the risk of worsened crow's feet:

  • Choosing the Right Injector:  Experience and skill are paramount. Look for a board-certified dermatologist or plastic surgeon with a proven track record in facial aesthetics.  During your consultation, discuss your goals and any concerns you have about crow's feet. A qualified injector will perform a thorough facial assessment, considering your anatomy, skin quality, and existing wrinkles. They should explain the potential risks and benefits of cheek fillers in detail and tailor the treatment plan to achieve your desired outcome while minimizing the chance of unwanted side effects.
  • Pre-Treatment Consultation:  A thorough consultation is crucial for setting realistic expectations and preventing complications.  Here are some key things to discuss:
    • Your facial anatomy: The injector will analyze your cheekbones, skin laxity, and pre-existing wrinkles to determine the best filler type, placement strategy, and amount of product needed.
    • Filler selection: Discuss different filler options focusing on those with a consistency that provides lift and volume without being excessively heavy. Hyaluronic acid fillers are a popular choice as they can be dissolved with hyaluronidase if needed.
    • Conservative Approach: It's always better to start with a conservative amount of filler and assess the results before adding more. A gradual approach allows for fine-tuning the treatment and minimizing the risk of overcorrection, which can exacerbate crow's feet.
  • Addressing Existing Crow's Feet:  If you have deeper crow's feet before fillers, consider incorporating Botox into your treatment plan. Botox injections relax the orbicularis oculi muscle, reducing the depth of existing wrinkles and preventing them from worsening after filler placement. Combining these treatments can create a more comprehensive rejuvenation effect.

What Expectations Should People Have About Fillers and Dynamic Wrinkles?

A Woman Getting Cheek Filler Treatment

It's important to understand that cheek fillers primarily address volume loss and static wrinkles. They may not directly target dynamic wrinkles like crow's feet, which form with facial expressions. However, in some cases, by restoring youthful volume to the cheeks, fillers can indirectly soften the appearance of crow's feet by providing better support to the underlying structures.

When Might Cheek Fillers Actually Improve the Appearance of Crow’s Feet?

There are scenarios where cheek fillers can actually improve crow's feet. Here's how:

  • Loss of volume in the apples of the cheeks: As we age, volume loss in the midface can cause the skin around the eyes to sag, making crow's feet appear more prominent. Restoring this volume with strategic filler placement can lift and tighten the skin, potentially softening the appearance of crow's feet.
  • Tear trough correction: Deep tear troughs can cast shadows that accentuate crow's feet. Filling this area can create a smoother transition between the cheeks and under-eye area, minimizing the shadows and potentially making crow's feet less noticeable.


Cheek fillers can be a powerful tool for facial rejuvenation, but it's important to be aware of potential side effects like worsened crow's feet. By choosing a skilled injector, having a thorough consultation, and managing expectations, you can minimize the risk and achieve a natural-looking, youthful result. If you do experience this side effect, remember there are options for correction. Consulting with your injector promptly allows them to address the issue and create a treatment plan that best suits your needs.

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