There’s been a sea change in the way women in their 20s view their faces, and with it comes the rise of many cosmetic treatments, including the polarizing ‘preventive Botox’. While the reasons are arguably as multifaceted as this generation itself, many would agree on one thing: The impact of social media cannot be understated. According to American Society of Plastic SurgeonsBotox injections have increased by 28% since 2010 among 20- to 29-year-olds. And the Zoom effect has only increased requests for cosmetic treatments, with Botox emerging as the top minimally invasive cosmetic procedure, according to American Society of Plastic Surgeons (ASPS) Plastic Surgery Statistics Report 2020.
While most doctors recommend focusing on skin quality with a proper regimen that includes daily exfoliation and SPF protection, as well as regular chemical peels or specialized treatments like Clear and Brilliant laser resurfacing during this decade, there are still exceptions. . If constant furrowing of the brow results in the first signs of an angry crease, or premature crow’s feet due to naturally thin skin is a persistent cause of frustration, injectables can help. But as any good dermatologist will note, there’s a caveat: When it comes to preventative Botox and filler, there’s a fine line between targeted tweaks and doing too much too soon. Here, sought-after experts share their advice for women in their 20s.
Botox vs Preventive Botox
What exactly is preventive botox and how is it different from regular botox? Botox is a neurotoxin injected to treat wrinkles and reduce the appearance of fine lines. According Deddy Engelman, MD, FAAD, board-certified dermatologist and Mohs surgeon at Shafer Clinic Fifth Avenue, works to block muscle contraction, causing the muscle to move less, resulting in smoother skin. Botox is injected over time at strategic points on the face where wrinkles are already visible. Preventive Botox, on the other hand, aims to treat wrinkles before they even start and requires less frequent visits. “[It’s] a cross between prevention and revitalization,” he says. “The idea is to start early to preemptively before visible lines form.”
The process
When you get preventative botox, you can expect a similar process to regular botox. Engelman says she’ll usually first cleanse the skin of dirt and makeup with a mild solution. He may then apply a topical numbing gel to the targeted area or use ice beforehand if the patient requests it. Then, with a small needle, he will inject into the skin and continue to vacuum the skin to minimize the risk of bruising and bleeding.
Aftercare is minimal (see our guide here) and she says you can continue with your normal routine for the most part. He advises not touching, rubbing or massaging the treated area for about 24 hours and avoiding work for about 48 hours after the injection.
When to Get Preventative Botox?
While most people will start to notice facial lines in their 20s, Engelman says there’s no magic number at what age you should start getting preventative Botox. you should evaluate your skin before making this call. “I recommend starting Botox injections when I see dynamic wrinkles or the skin starts to wrinkle and form small lines,” she says. “[This is all] to avoid the formation of deeper lines’.
Preventive Botox can help when used conservatively
When women in their 20s first consider Botox, prevention is often the primary factor, as early signs of aging—like crow’s feet, forehead wrinkles, and fine lines—begin to appear. “Lines get deeper with age,” she explains Patricia Wexler, MD, of Wexler Dermatology in Manhattan. “If you start [getting Botox] early enough and done right, you won’t need to [as much] in the future.” For younger patients wary of the frozen look—remember, young faces movement—Wexler wants to use lower doses of Botox through highly targeted microinjections given to specific areas of the face such as the forehead, eyebrows or around the eyes.
…But it will age you very, very quickly
Botox only lasts three to six months—and yet what’s less often discussed is this: Facial muscles naturally weaken over time, and overdoing it in a certain area could have unintended consequences. “If you do a lot of Botox on your forehead over many, many years, the muscles will become weaker and flatter,” warns Wexler, adding that the skin can also appear thinner and looser. Additionally, as your muscles become weaker, they can begin to recruit surrounding muscles when you make facial expressions. “If someone stops using their forehead muscles, they can start to squint using their nose and have wrinkles on the side of their nose,” she explains. Translation: You still need more Botox for the newly recruited muscles, says Wexler. To avoid these types of mistakes, diligent research by a doctor is essential, as is a conservative approach to injectables and asking questions about how treatment will be tailored to your individual needs.
The same applies to Fillers
“As we age, we lose volume in our face, and hyaluronic acid filler can be used as a replacement,” explains Wexler. “For younger women, the injections can be used to treat areas with acne scars or hollows under the eyes.” During your 20s, when the face is full and healthy, it has been argued that a shadowy look can even be quite charming. But in other cases, inherited dark circles can lead to a persistently tired look, where a few drops of under-eye filler can be helpful. As a leading dermatologist David Colbert, the MD is quick to note, however, too much Botox and filler distorts the face and will make you look older as a result. “When the line is crossed, everyone starts to look like they’re related,” he also warns of a uniform cookie-cutter look that lacks character or individuality. Or worse. “It’s a snowball effect of people liking something, coming back very soon [for even more]and then it gets really heavy,” adds Wexler.
Lips are hard—Period
Many doctors agree that the mouth may be the most obvious gift of labor that is done too early. Younger lips tend to have substantial volume and turn naturally at the corners, meaning the best strategy to flatter them often comes down to a good signature lip color. For women who remain self-conscious about the size or symmetry of their lips—think a slightly crooked appearance, for example—Botox can be injected into the orbital muscle along the lip line as an alternative to lip fillers. “When some people smile, the lip turns inward and they lose the upper volume,” he says Dara Liotta, MD, FACS, plastic and cosmetic surgeon based in New York. “This relaxes the outer layers of the orbicularis oculi muscle around the lips and looks much more natural than filler.” Additionally, injections along the jawline—or more specifically, the masseter muscle—have grown in popularity to relieve stress-induced jaw tightness and are also known to improve the area. “A lot of people hold tension in the jaw area, and when you relax that muscle, the chin comes out of the shadow of your lower lip,” Liotta explains.
Alternative ways to prevent wrinkles
For other ways to keep skin smooth that don’t involve injections, you have a few options. Engelman says that using sunscreen daily will help prevent sun damage, sunburn, and signs of aging. She also recommends looking for ingredients like vitamin A (the most common form includes retinol) and antioxidants that will promote cell cycle and collagen production and protect skin from environmental aggressors.
You can also turn to treatments in the office. She recommends chemical peels and microneedling as two that stimulate collagen production and reduce the appearance of fine lines.
