When is the Right Age to Start Botox?

How about Eight?

I think we can all agree that that is as ridiculous as it sounds.

This is apropos of a recent furore surrounding a woman who gave an interview to 'The Sun' and appeared on 'Good Morning America' to say she had given her eight year old Botox injections to give her a competitive edge in beauty pageants….

Child protective services, rightly, became immediately involved. She’s now claiming that the whole thing was a hoax and she did it for the money both the Sun ($200) and GMA ($10,000) paid her. Either way, she’ll have a tough time arguing to get her daughter back.

Anyway….back to the point…The short, quick answer to the Botox question,  if you are in a hurry, is:

There is no right or wrong time to start, if indeed you should start it at all.

It is a cosmetic procedure and it is completely elective. As a result, It is a very personal decision.

Interestingly, patients typically start treatment around the ‘crises years’ (29, 39, 49). It is the time people take stock and reflect on their lives or panic, depending on their disposition. They think about where they are, where they hoped they would be at this time in their lives and where they want to be in the next decade. How they look also gets a little attention...

“I will never be an old man. To me, old age is always 15 years older than I am.”
— Francis Bacon, Sr. quotes (English Lawyer and Philosopher. 1561-1626)

Everybody ages differently. If you smile, frown, or make any expression with your face (even squinting at the sun), you will develop laugh lines, brow lines, lines across your forehead, lines around your eyes, etc. They're a fact of life, and although there are ways to minimize them, we will all get them eventually.

Not all of us get all the lines in quite the same way or at the same age though. Genetics has a lot to do with that. Look at your parents: do they have any lines when their faces are a rest? Where are they? How many? How do they compare to their peers in terms of signs of aging? There is no avoiding your genes!

We usually associate the use of neuromodulators (Botox) with  people in their 40s, 50s and 60s attempting to fix wrinkles and folds once they’ve developed. But that has all changed. Ridiculous stories about eight year old’s aside, there is a growing movement towords preventative cosmetic procedures as the products and treatments become more mainsteam and generally accepted.

There is a growing school of thought that suggests that, by injecting earlier, people can keep lines from ever happening. That seems like a stretch to us and also doesn't sound very desirable. After all I love my wrinkles - just not all of them ;-).

This broadening of the market reach is not unexpected. Every generation embraces new tools and techniques to make themselves look and feel better.  From the innovators, through the early adopters all the way to the laggards, new tools in our arsenel for looking well follow the age old (pun intended) path towords widespread use. My granny’s generation were fond of the blue rinse and a wash, set and blow dry on Fridays. Now it is rare to see women (or men if they have any hair left…) rocking the blue rinse or looking edgy with a current cut on silver hair. (The latter can look amazing).

Also, Teeth whitening, unheard of 20 years ago, has become the most requested procedure in cosmetic dentistry today. 

We adapt.

The argument for Prejuvenation

Botox use in younger people is described as preventative use of cosmetic procedures, or “prejuvenation” if you want a trendy term.  Those that subscribe to this theory argue that it’s easier and more effective to inhibit progression than come in 10 years later and take them away.  An ounce of prevention and all that…

They argue that if you slow down the use of these muscles beginning early in adult life, the lines never develop. Rather than going backward and fixing something that’s there, you can inhibit it from starting in the first place. Akin to getting your teeth cleaned professionally to stop plague build-up and subsequent gum disease and hopefully ever having a filling, perhaps?

Botox's preventive aspect was proved in Beverly Hills plastic surgeon Dr. William J. Binder's groundbreaking 2006 twins study, where he injected one identical twin with the toxin for 13 years (from the age of 25). The result? The treated twin looked at least five years younger, in spite of living in sun-damaging Malibu (her sister lived in Munich). (We have included details of this study at the end of the blog).

Where do we stand her at LK Aesthetics head quarters?

Firmly in the middle!

We feel patients should wait until the lines actually show up but not so late that they have moved in permanently. The wrinkles should be there when your face is at rest. When exactly that happens is nature’s lottery.

How many wrinkles you have depends on your skin type and how much you move your face. Thinner complexions- typical for women with lighter hair, eyes, and skin tones - will develop more lines, faster. That pretty much sums up the Celtic complexion. Oh joy...

Pragmatically speaking, for early lines, botox is very effective in softenening them almost completely after the first session and the results tend to last a relatively long time. So based on botox's effectiveness, it would make little sense to try and prevent something that is easily treated and not yet present. However, once a line is more “etched” (after all we are a n evolving work of art…), it may take several sessions with botox prior to soften it.

In your late teens and early twenties there are much more obvious ways to keep your skin healthy and to prevent early onset of wrinkles. For the average person to start using Botox in their early twenties is overkill.

These are the things you should be concentrating on.

  • Use Sun block -sun exposure is cumulative. 5 mins a day is enough to break down collagen. We will discuss this further in a later blog.
  • Stay Hydrated – water, water and more water (even after they start charging us for it)
  • Don’t Smoke. At all. Ever. If you do –stop.
  • Get enough sleep – self evident but I may explore exactly what that means later.
  • Good Diet – I’ll blog on that one too
  • Use the best ingredients on your skin that you can afford – we’ll delve into that too anon.

Some patients who are in their early 20s and already have etched-in wrinkles, whether it is because of strong facial muscles and excessive sun exposure [or something else].

If you begin using Botox and fillers in your 20s, creases and wrinkles will be slower to develop. That doesn't mean they won't, it just means they will take some more time to show. Also, since these fillers are only temporary, you're signing yourself up for a lifetime of repeat treatments, at several hundred euros a treatment, along with gym membership, laser hair removal and hair colouring.

But the truth in today’s market is that people are prepared to do just that. More than 50% of our clients are <40 years old.

We can all agree that frown lines, forehead furrows and crows’ feet are due to repetitive folding of skin from normal expressions. What we would suggest is at whatever point people begin to notice or (more importantly) are bothered by some of these things like frown lines or forehead lines … it’s reasonable to consider starting treatment with Botox or to come in for a consultaion so you can learn more about it.

There are no ‘shoulds’, ‘Musts’ or ‘have to’s”

If you’re thinking about Botox, the best time to start is when the lines on your face are minimally visible. You’ll get the maximum benefit if you start before you’re deeply wrinkled.

It’s never too late to start though. You haven’t missed the boat. You have your own idea of how you should look and what age you would like to be.

Once wrinkles are deep Botox can help soften them, but it won't eliminate them.

Now some people are lucky and don't get lines and wrinkles until later on in life, so yes, for some, it is too early to have treatment in their 30s or early 40ies.  But by the same token, some people may have lines develop in their late 20s, so Botox treatment would be appropriate for them if they are bothered by them.

Botox is not for everyone, but if you have wrinkles that bother you, it could be for you.

At no point are we proposing a frozen look or starting Botox before you are emotionally or financially ready.

Where do I start?

Everyone has things they love about themselves and also they have their pet peeves. Starting early on the frown prevents wrinkles developing, but the jury is out on the forehead and eyes. The frown is a larger muscle, compared to muscles in the eyes or the forehead. The benefits of starting early on the frown can be obvious.

We recommend, you try Botox in one small area first, and if you like it, you can try it again. Treatment for younger patients is often called ‘Baby Botox’ or the ’Sprinkle Effect’ (just to help you in your google searches…). This is a diluted dose that will get rid of little wrinkles but won't leave the patient expressionless (or no more than usual – we can’t add any –sorry).

I am an advocate of Botox (and similar injections) as long as it is used in the right circumstances, on the right person with the right understanding, and to achieve the right result.

I liken receiving Botox to taking solpadeine when you have a headache. You take a little when you need it as opposed to a daily event. It works as it should and provides relief. It is not to be used as a crutch or to maintain your existence.

Don’t worry too much. You’re not making any long term decisions. Iit’s a temporary procedure (like changing your hair colour) if you don’t like it, it’s not going to be forever.

If you know you're somebody who's going in the direction of cosmetic procedures and you know that you're going to care about lines, then I say it's better to do it earlier than to wait and do it once these lines have etched into the skin.


Twins Study as promised...

Long-term effects of botulinum toxin type A (Botox) on facial lines: a comparison in identical twins.



To evaluate the presence of imprinted facial lines in identical twin sisters, one of whom had received botulinum toxin type A (Botox) treatment in the forehead and glabellar region regularly for 13 years and one of whom had not. Crow's feet were also compared.


One twin received Botox in the forehead and glabellar region (approximately 2 to 3 times each year over the past 13 years) and in the crow's feet (twice in past 2 years). Her twin received Botox only twice (in the forehead and glabellar region, 3 and 7 years ago).


Imprinted forehead and glabellar lines were not evident in the regularly treated twin but were evident in the minimally treated twin. Crow's feet were less noticeable when the regularly treated twin smiled (even at 7 months after treatment) than when the minimally treated twin smiled. Untreated facial areas (eg, nasolabial folds) showed comparable aging in both twins. Neither twin experienced adverse effects.


Long-term treatment with Botox can prevent the development of imprinted facial lines that are visible at rest. Botox treatment can also reduce crow's feet. Treatment is well tolerated, with no adverse events reported during 13 years of regular treatment in this study.