The eye area is the most fragile and age-revealing region of the face — eye skin is only 0.3-0.5mm thick (the thinnest on the face), with minimal sebaceous and sweat glands leading to poor natural hydration, combined with tens of thousands of daily blinks and rich expression muscle activity, making the eyes the first area to develop wrinkles. Periocular wrinkles are categorized into three types: (1) Crow’s feet — radiating lines extending from the outer eye corner, deepened by smiling, caused by contraction of the lateral orbicularis oculi. (2) Under-eye lines — fine horizontal lines in the under-eye area, related to orbicularis oculi contraction and skin dryness. (3) Eyelid lines — horizontal lines on the upper eyelid. Additionally, glabellar lines (between brows) and forehead lines typically appear alongside periocular wrinkles. Causes include hyperactive orbicularis oculi (dynamic wrinkles), photoaging (UVA destroying dermal collagen), skin dehydration, eye-rubbing habits, and repeated friction from eye makeup. Rappoel Dermatology near Gangnam Station, Seoul, uses Korea’s Coretox botulinum toxin — precisely injecting the lateral orbicularis oculi to safely and effectively eliminate periocular dynamic wrinkles and restore bright, youthful eyes.
Technical Advantages of Coretox Botulinum Toxin
- Korean-origin higher purity: Coretox is a 150kDa high-purity botulinum toxin type A developed by Daewoong Pharmaceutical — same type A as Botox (Allergan) but with different manufacturing processes. Coretox uses a unique purification process removing unnecessary complex proteins, theoretically reducing antibody formation and resistance risk — meaning for patients requiring long-term repeated injections, Coretox may maintain more consistent results over time
- Faster onset (3-day results): Coretox clinical data shows average onset of 2-3 days, faster than traditional Botox (5-7 days) — beneficial for patients needing quick results (e.g., pre-event treatment)
- Precise diffusion control: Coretox’s molecular properties result in smaller post-injection diffusion — particularly important in delicate areas like the periocular region, preventing toxin spread to non-target muscles (e.g., spreading to zygomaticus major causing smile asymmetry)
- Preservative-free: Coretox formulation contains no animal-derived proteins or human serum albumin — reducing allergic reaction risk, safer for sensitive patients
- Stable Korean domestic supply: Rappoel is located in Seoul, Korea — Coretox as a domestic product has stable supply without occasional import supply chain disruptions
Detailed Anatomy and Safety for Periocular Botox Injection
- Precise targeting of lateral orbicularis oculi: The treatment target for crow’s feet is the lateral orbicularis oculi (muscle fibers lateral to the outer eye corner). Injection must be 1-1.5cm lateral to the lateral canthus — too close may affect eyelid closure, too far yields insufficient effect
- Avoiding zygomaticus major and risorius: The orbicularis oculi overlies the zygomaticus major — if toxin spreads to the zygomaticus, it causes midface drooping and smile asymmetry (crooked smile). Rappoel’s strategy: 2-3 injection points per side, 2-4 units Coretox per point, injected in the superficial subcutaneous layer (superficial orbicularis oculi), avoiding deep injection that could spread to the zygomaticus
- Bony orbital rim landmark: All injection points are strictly lateral to the bony orbital rim — the physician palpates the orbital bone edge as a safety landmark, ensuring injections don’t enter the orbit and affect extraocular muscles
- Asymmetry assessment: No face is perfectly symmetrical — left and right orbicularis oculi strength and wrinkle depth may differ. Rappoel physicians carefully mark bilateral wrinkle distribution before injection, adjusting dosage per side based on actual asymmetry
- Avoiding over-treatment: Excessive orbicularis oculi injection can cause a fake smile appearance (eyes don’t move when smiling, looking unnatural) or worsened eye bags (orbicularis relaxation allows orbital fat bulging). Preserving some periocular expression is key to natural results
Rappoel Periocular Botox Injection Treatment Protocol
- Periocular assessment and plan design (10 min): Static and dynamic (smiling) evaluation of crow’s feet distribution and depth → assess under-eye lines → evaluate brow tail position and eyelid closure function → mark injection points (2-3 per side) → determine dosage (6-12 units Coretox per side)
- Disinfection preparation (5 min): Facial cleansing → povidone-iodine periocular preparation → physician wears sterile gloves → 30G ultra-fine insulin needle used for injection
- Precise injection (5-8 min): 2-3 injection points per side → injection depth at superficial subcutaneous layer (superficial orbicularis oculi fibers) → 2-4 units Coretox per point → gentle skin pinching during injection ensures superficial placement → immediate gentle pressure for hemostasis
- Immediate assessment and guidance (5 min): Patient performs smiling and blinking to confirm onset of muscle relaxation → post-care instructions provided → 2-week follow-up scheduled for effect evaluation
The entire periocular Coretox injection takes only 15-20 minutes, with results visible in 3 days, full effect at 7-10 days, lasting 4-6 months. Located 3 minutes from Gangnam Station Exit 10, with seamless English and Chinese consultation.
Frequently Asked Questions
Will periocular Botox affect my facial expressions? Will my smile look unnatural?
This is the most common concern, but correct injection does not affect natural expression. The keys are: (1) Dosage control — 6-12 units Coretox per side for crow’s feet is the safe effective range. Rappoel’s philosophy is relaxation, not complete freezing — reducing 70-80% of crow’s feet contraction while preserving 20-30% natural expression. (2) Injection depth — injected in the superficial subcutaneous layer (superficial orbicularis fibers), not deep enough to reach the zygomaticus major, avoiding smile muscle interference. (3) Injection points — 2-3 points per side distributed evenly in the safe zone 1-1.5cm lateral to the canthus, not near the eye corner or infraorbital margin. (4) Dynamic assessment — the physician has the patient smile repeatedly after injection to confirm natural results. Unnatural results typically occur from excessive dosage (over 15 units/side) or too-deep injection spreading to the zygomaticus — completely avoidable by experienced physicians. Rappoel’s goal is visibly reduced crow’s feet when smiling while maintaining lively, natural eyes.
What is the difference between Coretox and Botox? Which is better?
Coretox and Botox are both botulinum toxin type A with the same core mechanism (blocking acetylcholine release to relax muscles), with these main differences: (1) Purity — Coretox is a 150kDa high-purity toxin with unnecessary complex proteins removed; Botox is a 900kDa complex containing auxiliary proteins. Higher purity theoretically reduces antibody formation risk — more beneficial for those needing long-term repeated injections. (2) Onset speed — Coretox averages 2-3 days onset, Botox typically 5-7 days. (3) Diffusion range — Coretox has relatively smaller diffusion, safer in delicate areas like the periocular region. (4) Preservatives — Coretox contains no animal-derived proteins or human serum albumin, lower allergy risk. (5) Origin — Coretox is domestically produced in Korea with stable supply. Rappoel selects based on patient needs — Coretox recommended for those needing fast results or experiencing diminished Botox effect; Botox also available for first-time patients or those accustomed to it. Both last similarly (4-6 months).
Can under-eye lines also be treated with Botox? Is it the same as crow’s feet?
Under-eye line Botox treatment is not identical to crow’s feet and requires more caution: (1) Indication selection — under-eye lines are divided into dynamic (deepened by blinking and squinting) and static (present at rest). Botox only works on dynamic under-eye lines — static lines need combination treatments (e.g., PDRN injection, laser, filler). (2) Injection location — under-eye Botox is injected 1-2mm below the lash line in the infratarsal area, 1-2 points per side, 1-2 units per point (much lower dosage than crow’s feet). (3) Higher risk — under-eye injection may cause ectropion, worsened eye bags, or aggravated dry eye. Rappoel physicians assess eyelid elasticity and eye bag status before injection — those with eyelid laxity or prominent eye bags are not candidates for under-eye injection. (4) Effect — under-eye line improvement is typically less pronounced than crow’s feet (due to more complex etiology). Rappoel typically recommends combined crow’s feet + under-eye injection, but with very low under-eye dosage (total 2-4 units) for safety.
How long does periocular Botox last? Will I develop resistance from repeated treatments?
Periocular Botox typically lasts 4-6 months — because the neuromuscular junction gradually regenerates new acetylcholine receptors restoring muscle contraction. Factors affecting duration: (1) Individual metabolic rate — faster metabolism means faster effect fade. (2) Muscle strength — stronger orbicularis oculi may need higher dosage and lose effect faster. (3) Injection technique — precise injection into target muscle lasts longer. Regarding resistance: long-term repeated Botox injections may produce neutralizing antibodies causing diminished effect — incidence approximately 1-5%. Coretox’s high-purity formulation theoretically reduces antibody risk. Strategies to minimize resistance: (1) No boosters while effect persists (minimum 3-month intervals). (2) Use the lowest effective dose. (3) Switch toxin types if effect diminishes (type A to type B or different brand of type A). Rappoel records each patient’s injection history, scientifically managing intervals and dosage.
Can periocular Botox be combined with other treatments? What are the contraindications?
Periocular Botox can be safely combined with multiple treatments: (1) Same-day — HA fillers (tear trough, nasolabial folds in different areas), PDRN injection (different facial areas), mesotherapy. As long as injections aren’t stacked at the same point. (2) 1-2 weeks apart — laser treatments (fractional laser, IPL), do laser first and wait for skin recovery before Botox, or Botox first and wait for muscle stabilization before laser. (3) 2-4 weeks apart — thread lifting, recommend thread lift first and wait for swelling to subside before Botox, to avoid swelling affecting diffusion assessment. Contraindications: (1) Active periocular infection (stye, conjunctivitis). (2) Myasthenia gravis or Lambert-Eaton syndrome. (3) Pregnancy and breastfeeding. (4) Allergy to Botox components. (5) Ptosis or incomplete eyelid closure — caution with under-eye injection. Rappoel physicians take detailed medical history before injection to rule out contraindications.
Crow’s feet aging your smile and under-eye lines ruining makeup? Rappoel Coretox Botox — eliminate periocular wrinkles in 3 days!
📍 77, Seocho-daero, Seocho-gu, Seoul, South Korea
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