If you live in the New York City metro area and have disposable income, (or are on TikTok) it feels like getting Botox is inevitable. I may think that because I’m a beauty journalist — which means I basically walk through life with a sign on my (suspiciously smooth) forehead that says Ask Me About Botox — but I hear people discussing it all the time, even when they don’t know I’m listening. And recently, I’ve noticed the Botox question changing from “Should I?” to “When should I?”
“The new thing that’s happening very, very fast is people interested in preventative aging,” says dermatologist Dhaval Bhanusali, M.D. (who treats Martha Stewart, an 83-year-old who looks like she got the preventative-aging memo well before the rest of us). “My patients want to know the steps they need to gracefully age, whether it’s Botox every three or four months or something else—they want to put it on the calendar and build regimented schedules.” The thing is, the Botox schedule is going to be different for everyone.
What age should I get Botox?
I’ve asked dozens of dermatologists and plastic surgeons this question, and most say the time to get Botox is when you barely notice fine lines when your face is at rest. Still, an expert examining your face in motion would be able to see where your wrinkles are going to develop. (FYI, when I say Botox, I’m talking about the entire category of neurotoxins, or neuromodulators, approved for cosmetic use, including Botox Cosmetic as well as Jeuveau, Xeomin, Dysport, and Daxxify.) People age differently depending on so many factors — ethnicity and sun exposure chief among them — so it’s hard to say when that moment will be for you. “I’m conservative by nature, so for Botox, I usually say late twenties at the earliest,” Bhanusali says.
Seriously though, should I start Botox before I’m 30?
Maybe. But first, it’s important to find a provider you trust. “This is New York City, so if you give somebody a credit card, they’re going to swipe it,” Bhanusali says. Book an appointment at a medi-spa when you’re 25, and you don’t have any wrinkles, and the staff will probably suggest you try “preventative Botox” or “Baby Botox” (more on that below), but that doesn’t mean the treatment is right for you. I suggest making a few consultation appointments with different aesthetic providers when you’re in your mid-twenties, before you “need” anything. This will allow you to talk to experts and connect with someone you trust. “You want somebody who can objectively look at you and say, “Let’s not start yet, it’s not time,” Bhnusali says. “That’s somebody you keep seeing for a long time.”
Does preventative Botox work?
Kinda, but it’s important to recognize that “preventative Botox” is a term invented by marketers, not medical professionals. In theory, all neuromodulators could be considered preventative. Botox temporarily freezes your facial muscles for three to six months, which means the skin stretched over those muscles is moving less. When there’s less repetitive movement, the collagen and elastin in the skin maintain their integrity longer, which means you stave off wrinkles longer. “I’ve been injecting for 20 years, and prejuvenation is real,” says David J. Goldberg, M.D., a dermatologist at Schweiger Dermatology Group in New Jersey and New York. For example, in a study of identical twins over 19 years — one who got injections, one who didn’t — the twin who got the Botox developed fewer wrinkles.
What is Baby Botox?
Like microtox and mini-Botox, baby Botox isn’t a medical term, but it’s used colloquially to describe injections that soften your muscle movements without freezing them completely. IMHO, all good Botox is “baby Botox” because the best injectors use just enough of the drug to diminish muscle movements without making you look unnaturally immobile. “My patients who are millennials and Gen X are more aware of all the ways Botox can be used, so I’ve been doing a lot more pan-facial Botox,” says board-certified dermatologist Melissa K. Levin, M.D., the founder of Entière Dermatology. “I’m talking about a little bit, but maybe in more areas of the face.” The FDA has approved the cosmetic use of neuromodulators in forehead lines, frown lines, crow’s feet, and platysma bands, but many providers also use it for lip flips (to shorten the appearance of the philtrum), to decrease the downward pull of the outer corners of the mouth, in the masseter muscles (to soften the jawline), to adjust chin creases, to give brows a lift, and even to tweak your nose (which appears larger as you get older).
How long does preventative or Baby Botox last?
Generally speaking, when neuromodulators are injected on label the results last three to four months. However, if your injector uses a smaller amount (aka baby Botox) or is placed differently than the ones approved by the FDA, the results may only last one or two months. However, many providers point out that the more often their patients get Botox or the younger they start, the less they need it over time. “If you start younger, your muscle tone is solid, you need less, and you don’t need it as often,” Goldberg says.
Can preventative Botox make you look older?
Botox is only as good as the person who injects it, and that’s especially true the older you get. An amateur injector at a medi-spa may be good at softening the appearance of brow lines on people in their late twenties or early thirties, especially if they’re doing that same technique on multiple patients all day long, but you don’t want someone who does one-size-fits-all work. (For example, if an injector repeatedly freezes the muscles that allow you to lift your eyebrows, your forehead can start to look heavy and your brows might appear lower than they would if you had never gotten Botox at all.) “I get so nervous when people go to these fly-by-night spas, where it’s like a Groupon type situation for Botox,” Bhanusali says.
Good providers will adjust their technique based on how your muscles and face mature. And they’ll let you know when Botox is no longer doing much and it’s time to think about lasers, skin-tightening treatments, or a face lift to see a difference in your appearance. Because at some point, your search terms will change from “When should I start Botox?” to “Am I Too Old For Botox?” — regardless of how well you age.
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