15% of women under 40 say they would likely try Botox. Is the 'preventative' messaging working?

Botox has traditionally been sought out by older women looking to do something about the wrinkles they already have. But that’s changing. Now younger women are turning to the cosmetic treatment to avoid getting those fine lines in the first place.

That’s the idea behind preventative Botox, which Houston plastic surgeon Dr. Kristy Hamilton has seen explode in popularity over the past five years. “The summer of 2020 was when I started seeing younger patients coming in and asking about starting Botox to prevent lines,” Hamilton tells Yahoo Life. “What I tell them is that when you start to see lines linger when you’re not moving your face, that’s a good indicator that it’s a good time to do so.”

Data from the 2023 American Society of Plastic Surgeons report indicated that while patients between the ages of 40 and 54 account for the largest percentage of those getting Botox, treatments among patients from 18 to 39 years old have been increasing. “Many in Gen Z are starting preventative Botox, known by some as ‘Baby Botox,’ to stop wrinkles before they form,” the report reads.

Results from a recent Yahoo News/YouGov poll align with those findings. Among 1,677 U.S. adults surveyed in late March, 15% of women ages 18 to 39 said they would likely try Botox, compared with just 10% of women age 40 and older. This, experts say, indicates that the messaging behind preventative Botox — that when it comes to wrinkles, the best defense is a good offense — is not only spreading but also successfully convincing more people to start Botox sooner rather than later. But not everybody is buying in.

‘I want to get ahead of this problem’

Christine Cambus, a 36-year-old makeup artist living in New York, is someone who hopped on the Baby Botox train before it was a bigger trend. In her mid-20s, she started noticing expression lines in her forehead that weren’t going away. “When I turned 26, I decided to start doing Botox because I was like, I want to get ahead of this problem before it gets more intense,” she tells Yahoo Life. “Now here we are 10 years later and — not to toot my own horn — but people routinely think I’m still in my early to mid-20s.”

Baby Botox, aka micro-toxing, refers to using smaller doses of the neurotoxin (which isn’t always Botox brand) to temporarily paralyze muscles in the face. According to Hamilton, these dosage amounts vary. “It’s still customized on the patient because I’m assessing the intensity of their muscle movement, which is going to be different person to person just based on anatomy, age, all of that,” she says. “What we’re talking about is just less than a full [Botox] treatment … usually less than half of what is recommended by the pharmaceutical companies.”

Cambus receives 30 units for the injections across her forehead. “I get it up into my hairline,” she says. “I get my 11's and the very outward edges of my eyebrows because I want my brows to kind of tick up a bit at the end.” She believes that the injections she’s had over the years are the reason she hasn’t developed lines elsewhere, like crow’s-feet.

Hamilton backs this up. “It’s preventing the lines that are caused by movement, so if she’s getting a little bit around the corners of the eyes, that’s what is preventing her crow’s-feet wrinkles,” she says. But if Cambus were only injecting the 11's between her eyebrows, for example, it wouldn’t have that same preventative effect on the outside of the eyes.

‘I’m afraid of putting it in my face’

Jess Peachy, a 26-year-old from Charlotte, N.C., on the other hand, has been interested in getting injected since first hearing about preventative Botox on Bravo shows like Vanderpump Rules. But she has decided against it after doing further research.

“I looked into it, looked at other people’s TikTok videos about their experiences and everything seemed fine and seemed good and normal. Everyone was like, ‘My face isn’t moving, I’m not getting wrinkles,’” she tells Yahoo Life. “But what changed my mind about getting it was when people had masseter Botox and started discussing that after a while, they got the jowls.”

Peachy is referring to people having Botox injections in their masseter muscle along the jaw — not an area prone to wrinkling — and experiencing jowl-like drooping. Peachy worries that sort of effect could happen elsewhere on her face if she tried Botox. “At the end of the day, it is weakening your muscles, so I’m afraid of putting it in my face and the long-term effects of it,” she says. “I don’t want any muscle atrophy and to end up with loose and saggy skin.”

Dr. Sean McNally, a plastic surgeon in Oregon, tells Yahoo Life that there is a slight possibility of experiencing significant weakening. But he says it’s rare for people to be getting so much Botox so frequently to get to that point.

“If people are very consistently, very aggressively high-dosing Botox in certain muscles, and if they do that for years, those muscles can actually look weak and anemic, kind of pink instead of red. They do weaken with time,” he says.

But McNally adds: “For most people, they are not redosing their Botox before their Botox has completely worn off. So they’re going to have this break in between where the muscle is functioning and you're actually using it for a while and then redosing it. It’s not a long-term concern because if somebody is dosing you appropriately, they’re going to be weakening the muscles but not completely freezing them out.”

McNally himself has been getting injections for 12 years, starting when he was 31. If he hadn’t gone the preventative route, he says, “I would now have permanent creases that even with Botox wouldn’t go away.”

'Just something that Gen Z talks about’

The messaging of preventative botox is working when it comes to getting younger people interested and considering it. What was previously a part of beauty regimens and culture for older women is now “just something that Gen Z talks about,” says Hamilton. But that doesn’t necessarily mean that every young person is running to get it. For some, it’s concerns about the long-term effects holding them back; for others, it’s the price tag.

For those who are eager to begin, McNally encourages patients to wait until they’re 25. “I don’t think you’re going to get a ton of benefit out of it until you’re in your late 20s, early 30s,” he says, unless there’s an otherwise significant indication (like a skin or collagen condition) that someone younger should be starting.

Hamilton recommends that people of all ages be particular when selecting who is doing the injection. That’s especially important for young patients who don’t want to overdo it. “It's about going to someone that matches your aesthetic or understands your aesthetic,” she says. “So if you walk into the office and everyone is completely frozen and people don't have any movement, that's probably not the office for you.”