1 Question, 5 Answers is a column where we ask different types of healthcare pros to weigh in on the same issue.
For years, many people didn’t really consider getting Botox until they hit age 40. The dermatological procedure — which is used to smooth fine lines and wrinkles — allows recipients to take a dip back into the fountain of youth.
But that’s changed in recent years. More and more people in their 20s and 30s are starting to get the injections. In fact, since 2010, Botox injections have increased in people ages 20 to 29 by around 32 percent.
What’s more, is that while Botox has historically been seen as a cosmetic procedure, an easy gateway to smooth, plump skin, some young people are getting it done for preventative reasons. Instead of correcting already-formed wrinkles, preventative injections (also called “baby Botox”) supposedly curb large wrinkles from forming in the first place.
Social media, along with a general increased interest in skincare, are driving the trend. For instance, in March 2021, a young woman posted a video of herself on TikTok after receiving Botox at the age of 28. It quickly racked up more than 2 million views.
While typical Botox involves injecting a large amount of filler, typically OnabotulinumtoxinA, around the eyes or forehead to paralyze muscles and mitigate or reduce the appearance of wrinkles, “baby Botox” involves much smaller doses of filler.
Although studies say, generally, Botox can improve the appearance of facial wrinkles, there doesn’t appear to be much research looking at the longterm impacts of using it preventatively. Additionally, getting injections for cosmetic reasons is typically not covered by medical insurance. And most knowledge on the subject is anecdotal, based on what experts have seen in their exam rooms.
We asked five dermatologists and plastic surgeons for their thoughts on the benefits and potential risks of “baby Botox.” Some, like Dr. Paul Jarrod Frank, a New York City dermatologist, think it’s simply a marketing term, while others swear by its impact.
Dr. Konstantin Vasyukevich, MD
Plastic surgeon, New York City
Do you recommend preventative Botox?
It depends. We now believe in the idea of maintenance. You have to do the maintenance to prevent big things from happening. If someone has some faint wrinkles around their forehead, we can reverse that. When the lines become deeper, it’s trickier.
Some lines might seem pretty deep, but will completely go away with a higher dose of Botox. Some very deep lines might persist even after a lot of Botox is injected. There is a window of opportunity for you to reverse things; if you miss that window, things become irreversible. It is hard to define the exact timing when the injections can have the best preventative effect.
But luckily, the idea of prevention is to know that the problem is coming. A dermatologist or surgeon can assess the strength of a patient’s facial muscles during a consultation, and can recommend whether a low-dose Botox treatment is worth it.
What are some of the risks of getting ‘baby Botox’ treatments?
They have less longevity, so you might need to get them more frequently. Since “baby Botox” comes in low doses, it typically requires many more injections over time. The cost can vary from $500 to $1,000, with more experienced providers charging higher prices.
Dr. Michele Green, MD
Cosmetic Dermatologist, New York City
What is preventative Botox?
Research shows that filler injections can smooth out forehead wrinkles or crow’s feet. But if Botox is injected when you don’t have many wrinkles, or the wrinkles aren’t deep, it can prevent you from developing future wrinkles.
That’s because the injections treat dynamic wrinkles. Think about it like this, “If you never make a crease in the page of a book you never have to worry about smoothing it out.” If you stop their formation, then the wrinkles cannot form.
What other recommendations do you have to prevent the appearance of aging?
It is best to stay out of the sun, use sunscreen, and anti-aging skincare products like retinol and vitamin C.
Dr. Paul Jarrod Frank, MD
Cosmetic dermatologist, New York City
Why do you think we’re seeing more and more people receive Botox at a young age?
Aging starts in our early 20s, and some data has shown that some of the most popular non-invasive treatments, like Botox, have “preventative effects.” The millennial generation has caught on to the “clean up your room before it gets too dirty” phenomenon.
Do you recommend preventative Botox?
Using Botox on a wrinkle-less face is not its original intention. Rather than using Botox “preventatively,” people should start Botox when wrinkles first appear, to smooth out the skin. The term “preventative Botox” is usually more of marketing ploy.
Dr. Kiya Movassaghi, MD, FACS
Board-certified plastic surgeon, Eugene, OR
Do you recommend preventative injections?
Aging doesn’t start in your 50s. It starts in your 20s. I think preventative Botox is absolutely worth it. If you frown and your eyebrows are coming together, and you get folds between your eyebrows in your 20s, I can guarantee you by the time you are in your 30s, you will have grooves in your eyebrows. The best treatment for not getting them is prevention. If you get Botox earlier, the appearance of aging skin will slow down dramatically.
What are some other ways to prevent the appearance of aging?
With Botox, we’re not slowing down the process of aging. We’re slowing down one of the symptoms, which is wrinkle formation around the eyes. Sun protection is very important. Consuming alcohol is also very dehydrating to the skin, which results in more wrinkles and decreased elasticity. Alcohol can inhibit your skin’s ability to produce collagen, making it appear looser and more wrinkled.
Dr. Alexander Zuriarrain, MD, FACS
Quadruple board-certified plastic surgeon with Zuri Plastic Surgery, Miami, FL
Do you recommend people get ‘baby Botox’?
Ultimately, it is worth it. The older we get, the more wrinkles form, leading to aging signs. Nowadays, we can prolong our youthful appearance using a multitude of different techniques.
I have seen significant benefits when using Botox in patients beginning in their late 20s. It has helped to delay the formation of wrinkles on their forehead. It has relaxed the skin and allowed for a more youthful appearance over time.
What are some of the risks?
Beginning use of Botox at a younger age can cause a person to develop a resistance to the treatment if only one type of botulinum neurotoxin, the substance used in Botox injections, is used. That means a doctor might need to switch to a different type of filler down the road.