Botox for Crow’s Feet and Frown Lines Singapore

What Botox is and how botulinum toxin relaxes the muscles around the eyes

Botulinum toxin type A blocks the release of acetylcholine, the chemical messenger that carries the signal from nerve to muscle. Without that signal, the injected muscle relaxes over 3 to 14 days, and the lines formed where the contracting muscle folds the skin usually soften or disappear. The nerve endings regenerate over three to four months, restoring muscle contraction and, with it, the lines.

• Brands Botox (onabotulinumtoxinA) is one of several brands registered in Singapore, alongside Dysport (abobotulinumtoxinA), Xeomin (incobotulinumtoxinA) and Nabota. Clinic price lists often name the generic drug rather than the brand.
• Units Doses are measured in units. Botox and Xeomin units are roughly equivalent, whereas Dysport units follow a different scale, commonly about 2.5 Dysport units to one Botox unit, so a Dysport dose is numerically higher for the same effect.
• Muscles around the eyes The orbicularis oculi, a ring of muscle around the eye, creates crow’s feet when its outer portion contracts, and its lower-lid portion forms the aegyo sal roll on smiling. The corrugator and procerus muscles between the brows create frown lines and, together with the outer orbicularis, pull the brow downward. The frontalis muscle of the forehead is the only muscle that raises the brow, so relaxing these downward-pulling muscles allows the brow to rise, which is the basis of the toxin brow lift.

Botox results for crow’s feet, frown lines, brow lift and aegyo sal in clinical trials

• EvidenceEvidence for crow’s feet, Grade A. In a placebo-controlled trial of 445 patients, crow’s feet were rated none or mild at full smile one month after 24 units (12 per side) in 66.7% of patients, compared with 6.7% after placebo. A second trial of 917 patients showed a comparable benefit whether crow’s feet were treated alone (54.9%) or together with frown lines (59.0%), compared with 3.3% after placebo.
• EvidenceEvidence for frown lines, Grade A. In a placebo-controlled trial of 264 patients, 20 units injected at five points between the brows reduced frown lines at every follow-up visit, with the effect persisting to day 120 in many patients. In a Cochrane review of 65 trials (14,919 participants), patients were about 19 times more likely than with placebo to rate the treatment a success at four weeks.
• EvidenceEvidence for a brow lift, Grade B. In a series of 22 patients given 7 to 10 units into the outer orbicularis beneath both brows, the brow rose by 1.0 mm at mid-pupil and 4.8 mm above the outer eye corner at two weeks. In a randomised dose study of 79 women, 20 to 40 units between the brows also raised the brow, with the peak at 12 weeks, whereas 10 units briefly lowered it.
• EvidenceEvidence for aegyo sal and under-eye wrinkles, Grade C. In 15 women, 2 units injected into the lower-lid muscle softened under-eye wrinkles and widened the eye opening by 0.5 mm at rest and 1.3 mm on smiling. When crow’s feet were treated in the same session, the widening increased to 1.8 mm and 2.9 mm, and the effect was more marked in Asian eyes. No study has measured the size of the aegyo sal after toxin.

A Korean expert consensus for Asian patients recommends lower doses than those used in the Western trials, reflecting the generally smaller facial muscle bulk of Asian patients. The recommended doses are 7 units per side for crow’s feet, 8 units for frown lines and 1 to 2 units per side beneath the eye.

Botox price in Singapore (2026) for crow’s feet, frown lines, brow lift and under-eye

Prices are per treatment and compiled from published Singapore clinic price lists, some of which are nett and some of which exclude GST. At the same clinic, abobotulinumtoxin (Dysport) and incobotulinumtoxin (Xeomin) are priced slightly below onabotulinumtoxin (Botox). Quotes are comparable only when they state the number of units, because a lower price per area can reflect a smaller dose.

Botox side effects and risks around the eyes

• Drooping eyelid Upper-lid droop, mostly mild, occurred in 5.4% of patients treated for frown lines in the 264-patient trial. It results from toxin diffusing to the levator, the muscle that lifts the upper lid, and resolves as the toxin wears off.
• Brow drop or a raised outer brow Brow ptosis (a lowered brow) was more frequent than with placebo in a meta-analysis of 5,298 participants treated for upper facial lines. It occurs mainly when toxin reaches the frontalis. In the dose study, a low dose of 10 units between the brows briefly lowered the brow. A peaked, raised outer brow can follow when the central forehead is relaxed while the outer frontalis continues to pull upward.
• Lower-lid problems In the dose-finding study, all 8 women given 8 units per lower lid reported bothersome swelling or incomplete eye closure, and under-eye doses are therefore kept at 1 to 2 units. Festoons (swollen folds beneath the eye) have been reported after under-eye toxin in a patient with previous lower-lid surgery. A weak or lax lower lid is a reason to avoid under-eye toxin, because the orbicularis also supports the lid and pumps fluid away with each blink, and relaxing it can let the lid sag or swell.
• Smile changes Toxin that diffuses downward from the crow’s feet injection sites into the zygomaticus, the muscle that lifts the cheek and the corner of the mouth, can temporarily flatten the smile.
• Other Eyelid swelling and altered eyelid sensation were both more frequent than with placebo in the meta-analysis, and a bruise can form at a needle point. All of these effects are temporary, and those caused by the toxin resolve as it wears off.

Frequently asked questions about Botox for crow’s feet and frown lines

General information, not medical advice. A registered medical practitioner should be consulted before any treatment. Dark Eye Circles Singapore does not sell treatments.