Is Botox Preventative?

A reader recently emailed and asked me if there was an advantage to starting Botox at 40 before she had any lines etched—or if it made sense (and was more cost effective) to wait and do it once she noticed lines didn’t disappear anymore when her face was at rest. I started Botox at 33 so you already know where I fall on this issue, but I did ask Gary Goldenberg, MD, Assistant Clinical Professor of Dermatology at The Mount Sinai School of Medicine in New York City, for his opinion.

Turns out Dr. Goldenberg started getting Botox at 26 and tells his patients “my forehead hasn’t moved in fourteen years.” He, like me, believes that earlier intervention often translates into money saved later on because your skin is simply in better shape as you round the corner to 50, 60, 70, or even 80.

Consider this: You’ve got linens spinning on hot in the dryer. If you pull them out right at the end the cycle, wrinkles are easy to smooth as you fold. But if you delay, say, twenty minutes and the linens cool inside the drum, when you finally pull them out, the wrinkles have set and the only way to smooth them out now is with a heavy dousing of linen spray and a hot iron.

Similarly, if you allow years to pass without Botox, lines will deepen and etch into the skin. Maybe you’re fine with that (and if you are, this post is probably not for you anyway). But if you’ve waited until you see lines all the time, even when you're staring poker-faced at yourself in the mirror, Botox is probably not enough to erase them anymore. “Patients that wait until their mid-fifties or so to start Botox usually also need some laser resurfacing to smooth out their lines, or filler to plump it up, in addition to the Botox,” explains Dr. Goldenberg.

So maybe you saved time and money by skipping Botox once or twice a year as part of a prevention plan, but now you’re going to have to part with a grand or two for lasers and fillers to score the smooth results you really want. And if you really procrastinate on aging intervention, then wake up in your late 60s and decide you want major change, you’re looking at $20,000 for a facelift. Just food for thought.

As I wrote above, I started early with Botox and have gotten it a couple times a year for the past decade. I am not completely fine-line-free (and I'm okay with that). But I do believe starting early and conservatively has kept my skin in smoother, more supple condition than if I’d waited.