Can
getting injections in your twenties really prevent wrinkles later on?
If you watch enough Bravo reality shows or wait for a
table at enough popular brunch spots, you’re bound to hear twentysomethings
make mention of "preventative botox."
As the product on the forefront on the noninvasive
procedures trend (with fillers like Juvederm and Restalyne, anti-aging
micro-current treatments such as Ulthera, and fat-freezing treatments like
CoolSculpting not far behind), botox works by weakening or paralyzing certain
muscles or by blocking certain nerves, according to the U.S. National Library of
Medicine. It has been used to treat a range of issues, from wrinkles to severe
sweating, uncontrollable blinking, chronic migraines, and more.
The procedure entails getting botox (a popular brand
name of the drug Botulinum toxin type A) injections before wrinkles have formed
on your face to prevent them from forming, versus trying to correct them later.
While botox procedures
have been steadily on the rise since the early 2000s, the sizable buzz around
preventative botox has only begun in recent years. One of the main reasons for
its popularity, and the popularity of procedures like it, is the temporary
nature of the results — it’s rarely a one-and-done type deal. Like what you
see? Get ready to shell out more dough just a few months from now… and a few
months after that, for as long as you want your results to be maintained. So,
the question is: Is potentially being forever wrinkle-free worth getting
needles stuck in your face a few times a year for the next several decades? Is
preventative botox more than a ploy to get younger and younger people aboard
the cosmetic-enhancement train?
Botox has remained in
the top spot when it comes to the most popular minimally-invasive procedures
for years. According to the American Society of Plastic Surgeons’ 2015 Plastic
Surgery Statistics Report, the amount of botox administered on people ages 13
to 19 in 2014 was up by 7% — a 19,170 person increase — from the previous year.
(Conversely, for what it’s worth, the top two most popular cosmetic surgical
procedures — rhinoplasty and breast augmentation — have both decreased during
that same time period.) The same year that study was published, Vogue briefly
tackled the trending topic by talking to NYC-based doctors, some of whom said
that getting botox before wrinkles form is presumptive, not preventative. They
also cautioned jumping the gun because it can potentially cause the face to
look older more quickly.
Despite these warnings, many dermatologists and
plastic surgeons say there are few drawbacks, if any, to starting botox
injections pre-wrinkles. Atlanta-based plastic surgeon Dr. Carmen Kavali, 46,
regularly administers botox to patients and has been getting injections herself
for the past 14 years. "I started with my crows’ feet, because that’s where
I was starting to see small lines," she says. "Once I was seeing
results from my crows’ feet treatments, I started treating my '11s'
prophylactically." "11s" is shorthand for wrinkles in between
the eyebrows that resemble two vertical lines. "Now I have no 11s at
all," Kavali says, and she plans on getting botox treatments "for
life." She explains that the plus side of regular treatments is that you
can begin spacing them out after a few years, from every three to four months
to every six to eight months.
The youngest botox patient Dr. Kavali has injected
with botox was 19 years old. While botox is FDA-approved for people between 18
and 65 years of age, she says doctors can opt to use it off-label in patients
both younger and older, as long as the off-label use is disclosed to the
patient. "For anyone under the age of 18," she explains, "a
parent or legal guardian would have to consent, unless the youth is emancipated
and doesn’t legally require adult consent."
Esthetician and
cosmetologist Tiffany Bioski says that her job was what first prompted her to
begin getting botox six years ago (she’s 31). "I actually debated with the
topic for about a year, then I had a thought, 'Would I take dental advice from
a dentist with crooked teeth?'" She began getting preventative botox at 25
after realizing that "if I wanted to be proactive, I would have to be
preventative." Bioski adds that, through her education, she knew that if
she started earlier, she’d need eventually need fewer injections less often.
"It was the most logical decision for me and my lifestyle," she says,
adding that her results from getting preventative botox were "in a word,
phenomenal."
While Bioski doesn’t administer botox through her job,
plenty of clients have asked her about it, and she does mention precautions.
"I adhere to a 'less is more' policy — most people don't want to appear
constantly surprised or walk out with a droopy eyelid." She says side
effects can include tenderness, swelling, headaches and flu-like symptoms.
"I encourage people to do their research."
While various studies
have been done on botox and its effects, less has been published specifically
on preventative botox. It’s also worth noting that no studies have come out to
definitely say that preventative botox can actually prevent wrinkles from
forming, though many medical professionals enthusiastically stand by the claim.
In late 2013, the
Journal of the American Medical Association’s Dermatology sector published an
opinion article by two Massachusetts-based skincare physicians claiming it was
"rarely too early" to begin getting injections, fillers, and other
noninvasive treatments. The article goes so far as to say that the injection of
soft-tissue fillers earlier on could help stimulate collagen production, making
results last even longer and possibly making the need for re-injections no longer
necessary. However, "We’re not advocating treating infants, children and
people in their teens," co-author of the piece Dr. Kenneth Arndt tells
TODAY. The same article also quotes him explaining that it’s easier and more
effective to prevent progression versus beginning 10 years later — he calls it
"prejuvenation."
For some, wrinkle
prevention is merely an added bonus of getting botox in your 20s. Meghan, a
32-year-old international account executive and operations coordinator for a
clothing brand, started getting injections six years ago to help correct a
high-school sports injury that left her with nerve damage on the left side of
her face, resulting in a sagging eyelid. "Plus," she says, "when
I smile my right eyebrow goes crazy high, which makes me self-conscious in
pictures." Meghan says she’d much rather just get botox over the
alternative eyebrow lift — "I do not plan to go under the knife anytime
soon," she adds, "so I plan to keep getting it for a while."
Regardless of the
supposed effects, what’s inarguable about getting botox procedures earlier in
life is that it’ll cost you. Botox can range from approximately $200 to $500
(or more) per session, depending on factors like the doctor, injection sites,
and number of injections. If you get injections three times a year, that’s $600
to $1,500 annually. If a 25-year-old woman began getting botox, by 35 she would
have spent anywhere from around $6,000 to $15,000 total, or perhaps a little
less if she eventually decreased the number of annual sessions. (According to
the nonprofit research company Catalyst, the median income for a full-time
working woman in the United States is a little under $40,000 a year.)
Georgia-based dermatologist Rutledge Forney has herself gotten preventative
botox, and says the only downside she can think of is the cost. "But, as
with your 401(k)," she says, "a little investment today will pay off
in the long run."
Whether you’re needle-averse, strapped for cash or
just don’t feel comfortable filling your face with low-grade muscle-paralyzing
bacterial toxins, there are, of course, alternatives for working to prevent
wrinkles. "The most obvious skin prevention tool is sunscreen," says
Dr. Forney. "Use it aggressively and you will not have to pay to have
brown spots removed or your skin cancers cut off — same with botox."
Noting the steady increase in botox’s popularity in
the last several years, Live Science has reported that many experts feel
preventative botox is an unnecessary procedure — basically, if you begin these
treatments in your 20s for wrinkles that may not have shown up until your 40s
or 50s, that’s a whole lot of cash spent to keep something at bay that may not
have developed until decades later anyway. This reasoning is coupled with the
risk of the potential negative side effects like speaking, breathing, or
swallowing issues and muscle weakness.
It’s hard not to take in all the rave reviews docs and
derms offer when it comes to preventative botox (and let’s be honest, the
thought of having skin that’s nearly as smooth, luminous, and wrinkle-free in
20 years as it is now is pretty appealing). For those with enough cash to shell
out more than a grand each year to prevent facial lines with an unknown ETA,
the general consensus seems to be that the results will be worth it. For the
rest of us, we can probably just stick with a once-in-a-blue-moon facial and a
good daily SPF — at least until those 11s start to show up.
CAROLINE COX
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