From 2000 to 2019, injections of Botox — a neuromodulator scientifically known as botulinum toxin, which blocks certain nerve signals to muscles — rose 878 percent in the United States, according to a report from the American Society of Plastic Surgeons. 2019 (pre-pandemic) statistics indicated that the age group of people seeking Botox is younger than ever with ages 20 to 30 comprising 20% of all botulinum toxin procedures in that year. The question that seems to loom large is at what age should young men and women start Botox? Is earlier better? 

The reality is that both Botox and Dysport are becoming increasingly more popular among twenty-somethings.


When Should You Start Botox?

We have learned over the years that it is better to prevent static lines from appearing or becoming deeper versus trying to diminish the already etched in lines. We can also often use lighter dosing for patients who are younger, as well, which is a plus for patients. There are no clear-cut “rules” as to when a person should begin Botox as each person ages at a different pace. A good rule of thumb for both the patient and the doctor to evaluate a candidate is when the patient begins to notice fine lines that did not exist before. 

As a board-certified plastic surgeon, I can tell if a 20-something patient needs Botox by evaluating his/her face in a consultation. I will ask them to make several motions such as furrowing their brow, pursing their lips, and smiling wide, to identify areas that need injecting. If there is a slight crease forming between the brows, I will use a small amount of Botox to help train the facial muscles to no longer make that expression. This will help prevent the formation of deeper wrinkles that can be harder to correct in later years if left untreated. 

Preventative Botox

Today’s twenty-somethings are much more involved in preventive skincare, taking precautions against sun damage, and not smoking as opposed to previous generations. The advantage of preventative Botox is that it aids in keeping the muscles weak. The benefit is that as one ages, you don’t need as much corrective Botox, later on, fewer treatments are needed, and the results will be longer-lasting. I am cautious when injecting young people, that it does not have the opposite effect of aging them, as too much Botox can make one look older. Atrophy of the facial muscles can occur from overuse, especially around the eyes, so a light hand and knowing when to stop injecting is key when it comes to injection skills, doing what is suitable for the patient, as well as not giving a twenty-something a “frozen face.” 

There are also uses for Botox that 20-somethings request that are cosmetic, rather than anti-aging. In my practice, I also use small doses of Botox in the muscle above the lip as a “lip flip” to make the lip look fuller. If a patient would like slight jaw slimming, (if appropriate), I will inject Botox in the muscles at the corners of the jawline and in the columella area below the nose if they wish to raise the nasal tip a millimeter or so. 

I stress to my young patients that a healthy lifestyle is the most essential “youth factor." I am well aware of the pressures they face with an Instagram and selfie culture, and I will not let them succumb under my care to an unnatural look. 


About Dr. Michael Horn

Board- Certified Chicago, Illinois Plastic Surgeon

With more than 10,000 breast augmentation surgeries performed during his career of more than 23 years, Dr. Horn is known in the Chicago land area as the authority on breast augmentation. His artistic eye, mastery and surgical skill in performing various face and body procedures, his dedication to patients’ safety, combined with his focus on unparalleled care and attention, make him one of the most sought-after surgeons in the Midwest.

Dr. Horn earned his medical degree at Loyola University in Chicago. He completed a general surgery residency with the Medical College of Wisconsin, as well as a sub-specialty training in plastic surgery with a second residency at Loyola University. Dr. Michael Horn is board certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons and the Chicago Society of Plastic Surgeons. Dr. Horn is a frequent lecturer on the subject of plastic surgery and his work has been featured in several professional publications. 

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