I was at a plastic surgery conference last year and the host speaker at the conference told us how his 18 year-old daughter brought up the subject of BOTOX®. She wanted to know why she couldn't get Botox to "prevent aging." So he in turn posed the question to all of us plastic surgeons in the audience.
"Who in the audience would recommend using Botox to those in their 20's?"
It turned out that more than 90% of the audience felt it was safe and would, in fact, recommend using Botox in younger patients to "prevent" facial aging.
This got me thinking about the topic, and it brought to mind my shirt analogy I always tell my younger patients. Just as a shirt becomes creased at the elbow due to continual bending at the arm, in a similar way whenever we frown, squint or smile, our facial lines and wrinkles form and then eventually, over time, 'set' into the surface of the skin.
If someone in their 20's begins Botox treatments, the Botox is then preventative, rather then a corrective treatment. When injected correctly in the face by a trained plastic surgeon, Botox temporarily "freezes" the facial muscles that cause frown lines and wrinkles. I normally recommend that patients use Botox every 3 to 6 months to keep wrinkles from coming back and preventing the facial muscles from regaining their strength. Well, that same thought process leads me to believe that with Botox use from an early age, those facial muscles never become strong enough to form those wrinkles which make us look older, more tired, and even angry.
Recently, a patient of mine, in her early 20s, came into my office to get her first Botox treatment. At first glance, you would not think that she would be an ideal candidate for Botox, as she had no visible frown lines or wrinkles. The main reason for her visit, however, was not to get rid of wrinkles but to prevent the aging process. She also brought up a common concern of not wanting to look like a typical Hollywood starlet on the red carpet that appears frozen like a "deer in a headlight" without any facial expression.
I believe in order to get a conservative look, patients need to make sure that they see a surgeon who is well versed in the anatomy of the muscles of facial animation and who uses the right quantity of Botox in just the right areas. The key, in my opinion, is to not look "done" or expressionless, but rather to stay looking young, refreshed, and rejuvenated.
Needless to say, my young patient loved her results! And her friends who had not been supportive of her getting Botox at such a young age, did not even notice that she had anything done, but did comment on how "fresh" she looked recently.
By: Dr. Jimmy S. Firouz