What’s the deal with preventative ’baby botox?’ : NPR

Botox is becoming increasingly popular among people in their 20s looking to prevent wrinkles.

Clinics sell so-called “baby Botox,” a lower-dose treatment that is prescribed less frequently than for middle-aged adults—perhaps only once or twice a year.

Patients share the process in online videos. filmed from injector roomsasking for touch-ups to erase the hint of crow's feet or the 11 lines between the eyebrows.

It may seem absurd that someone so young would worry about aging. But patients say that using Botox, like using sunscreen, is preventative.

Botox is the brand name for botulinum toxin type A, an injectable neurotoxin derived from the bacterium that causes botulism. Other brands include Dysport, Xeomin and Jeuveau. When administered in small quantities, the drugs block nerve signals in the muscles, causing them to relax, thereby temporarily reducing the appearance of wrinkles.

Lawyer Stephanie Moore started taking Dysport when she was 27 to slow the formation of wrinkles around her eyes, which she attributes to her expressive face.

She pays about $460 per visit and says these injections three times a year are one of her favorite ways to pamper herself: “I feel so much more confident.”

Is age just a number with baby botox?

There are no complete statistics on which age groups receive Botox, but data from the American Society of Plastic Surgeons shows that between 2019 and 2022Use of injectable neurotoxins has increased by more than 70% in all age groups under 70, including Gen Z adults.

It is not approved for use by minors, so the youngest person who can receive Botox is 18 years old.

Demand for other types of aesthetic procedures and surgeries, including cheek implants and fillers, has also surged in the wake of the COVID-19 pandemic.

This timing is no coincidence, says sociologist Dana Berkowitz, author of the book Botox Nation: Changing the Face of America.

During the pandemic, people's lives migrated to virtual spaces. These included young people who had such experiences in their formative years. They attended high school or college via Zoom during the day and took to TikTok and Instagram to connect in the evenings.

Berkowitz says that by viewing carefully curated images of other people more frequently, people inevitably compared those faces to their own.

At the same time, some celebrities as well as social media influencers are now openly earning income by endorsing various beauty treatments, further normalizing it, Berkowitz said.

Although 20-year-olds seem young for Botox, Dr. Christy Hamiltonboard-certified plastic surgeon in Houston, says younger people may start to show signs of aging—it has a lot to do with genetics and sunscreen.

“Sometimes we see people in their 20s who have a lot of wrinkles, and that's just life,” she says.

But what's wrong with having wrinkles?

Ageless beauty is seen as a “status symbol” in modern society, says Berkowitz. The young women she studied told her that these treatments showed that they were able to invest in themselves at a very early age: “It was like they were part of an elite social club.”

As Berkowitz explores in his book, failure to conform to society's definition of female beauty can result in a professional tax. “Our ideal femininity is youthful,” she says.

Research shows that people who are considered beautiful are treated better, says David B. Sarver who studies the psychological aspects of appearance and beauty treatments at Temple University College of Public Health.

Sarver points to the extensive literature on how attractiveness can positively influence academic performance, professional growth and legal outcomes. One study even found that newborns deemed more attractive by hospital staff were held more often.

“It can make some, dare I say it, strategic sense for people to say, ‘I want to find a way to improve my appearance,’” he says.

Are there any risks if you start at a young age?

Botox was first approved by the Food and Drug Administration for cosmetic use in 2002. Doctors interviewed for this article note that millions of people have since received it safely.

Reports of dangerous side effects are extremely rare and are usually related to fake or misused botox.

Some risks still exist. First, it may stop working because your body is resisting it.

This can be upsetting for patients, they say. Dr. Paul DurandBoard Certified Plastic Surgeon in Miami. He hasn't seen any research explaining why this happens, but suggests that younger people may be at higher risk due to their stronger immune systems.

Another concern is that too much Botox at too high a dose can cause excessive muscle atrophy or contraction over time. Since we still lose facial volume as we age, a person's face may begin to look hollow rather than youthful.

Duran says well-trained doctors can avoid this outcome by not overdoing it, meaning by not injecting too deeply or using too much of the drug. But assessing a doctor's skill level can be difficult for patients.

Any physician, regardless of specialty, can legally perform cosmetic injections without special training or certification. Including dentists.

Durand and Hamilton recommend seeing a plastic surgeon or dermatologist. Although Berkowitz says there are qualified injectors outside of these specialties. She recommends that a patient interested in Botox ask friends or family for a referral.

Most people who receive cosmetic procedures they say they are happy with the result. Sarver says patients who are most satisfied tend to address their dissatisfaction with a specific feature—like Moore's desire to soften the lines around her eyes.

But evidence about how these procedures improve self-esteem and quality of life is inconclusive, Sarver says.

When cosmetic patients chase an unattainable ideal of beauty due to mental illnesses such as body dysmorphic disorder or severe depression, Sarver says Botox and other treatments do not improve their symptoms.

He explains that these patients are “better treated by a mental health professional than by a plastic surgeon.”

A lifelong habit… and expense

Durant turns away patients who want so much Botox that it will effectively freeze their face, leaving them unable to express emotion. “It looks terrible,” he says.

But in his experience, someone determined enough will eventually find a doctor who will say yes, given that administering Botox can be a lucrative source of income with relatively little overhead.

Not only the level of training and qualifications of doctors differ, but also prices. As Berkowitz warns, subsidized treatment is unlikely to produce the desired results. Amateur Botox can lead to a clearly doctored face.

And there's another problem: Once patients start taking Botox or a similar injection, they're unlikely to stop, says Berkowitz: “If you have people in their 20s, you have a lifelong user.”

Berkowitz herself is one of those lifelong users: She started getting Botox at 32 and now, at 47, needs higher doses and pays about $800 per appointment.

For someone starting young, that money—which can add up to tens of thousands of dollars in their 20s and 30s—could be used to pay off student loans, invest in their future, or travel the world.

If you stop taking the injections, the effect will wear off and the wrinkles will appear again.

Thus, Botox is addictive, argues Berkowitz, who admits its use runs counter to her feminist ethics of decentralizing appearance.

But Hamilton, the Houston plastic surgeon, says that for many of her younger patients, Botox is simply part of their overall investment in their health and appearance.

“Gen Z has a completely different perspective on these things,” she says. “It’s part of their self-care. It's part of their health.”

Stephanie Moore of Pittsburgh says improving her appearance with Botox makes her happy. She notes that her husband has tattoos, which she considers unnecessary and expensive.

“But it’s his body and his choice,” she says. “And this is my body and my choice.”