Does preventative Botox actually work?

If you’ve seen the recent BBC article floating around titled “Why I had Botox aged 23”, you’ll know it’s reignited quite the conversation about preventative toxin. The idea sounds simple enough: get toxin injections early, stop lines before they even form, and stay smoother for longer. But does it really work that way? Or is it just another concept that helps us part with our hard-earned cash … with a healthy dose of ‘anti-ageing’ pressure too?

Here’s what you need to know…

What is preventative toxin?

“The term ‘preventative Botox’ describes the use of botulinum toxin prior to the development of lines and wrinkles with an intent to prevent them occurring,” explains the cosmetic doctor Fiona McCarthy. “The concept has gained momentum over the last five years among younger patients who want to preserve smooth, wrinkle-free skin as long as possible. This approach differs from “corrective Botox” which is the use of neurotoxin to reduce or improve the appearance of existing lines.”

Where did the idea come from?

Logically, it does stand to reason that preventive treatment could work. After all, if you poleaxe the muscles that make you frown in your 20s, your expressive frown lines probably won’t harden into the permanent lines and wrinkles that show up 10 years later.

There’s also some clinical evidence to support it. The best known is a study that followed two identical twin sisters for 13 years, which found that the twin who had toxin two or three times a year in her forehead and between her eyebrows really didn’t have any visible imprinted lines in those areas by her mid-thirties, but her twin did, whereas the lines on other areas of their faces (eg, the nose-to-mouth lines) were much the same.

So, preventative Botox does work?

Yes – but there is a “but”.

While toxin injections will work to reduce muscle movements and therefore work to keep your skin smooth, not all practitioners are convinced by the concept.

In particular, it’s not just a question of whether it works or not. There’s the matter of whether it could be doing more harm than good…

What are the potential drawbacks of preventative Botox?

Will preventative Botox stop me from ageing?

Simply put, no.

Nothing is going to stop the ageing process completely – and overall ‘skin health’ and therefore how old your complexion looks, isn’t just impacted by how many lines you have. Regardless of your use of toxin, your collagen and elastin production as well as skin repair processes will slow down over time, leading to sagging, dark spots and texture irregularities if not wrinkles.

“Preventative toxin can be a useful tool in delaying certain visible signs of ageing, but it is neither a comprehensive nor permanent solution,” reveals Dr Sam Adam, the lead cosmetic surgeon at Brighton and Hove Cosmetic Clinic. That means that despite starting young to ‘stop ageing before it appears’, toxin alone isn’t going to be a one-and-done solution.

Is preventative Botox expensive?

How much your toxin injections cost is subject to a few things – not least the experience and location of your practitioner. But it’s common sense to realise that the sooner you start, the more expensive your treatment plan will become over time.

“Botox is not a one-off treatment,” confirms McCarthy. “Once started, maintenance is required to sustain results,” so the cost will really start to tot up.

Does preventative Botox make you look older?

The great irony is that any anti-ageing treatment can actually push the clock forward not back if you over-do it, and that’s especially true with toxin injections. If you have too much toxin, or it’s inexpertly injected, you could end up with eyebrows that shoot skyward or collapse down onto your eyes or start to drift sideways towards your ears, or you just look weird and blank, which isn’t a great look at any age.

And, of course, this risk is increased the more often you have it. “Heavy (or unnecessary) use of neurotoxin at a younger age can sometimes have the opposite effect, resulting in an unnatural or prematurely aged appearance,” says McCarthy.

Is the evidence for preventative Botox as good as it appears?

Yes, there’s some evidence it works, but practitioners are still concerned that high-quality scientific evidence doesn’t (yet) support the long-term benefits of preventative Botox in terms of skin ageing.

“The scientific studies often cited for the preventative approach to toxin have considerable variability in methodology and the results can not be reliably extrapolated to clinical practice in younger people (in my opinion!),” warns McCarthy.

So, considering that – as previously mentioned – treatments can be expensive, you might want to question whether the value of starting younger is really worth it.

Can preventative Botox cause ‘perception drift’?

The other issue of starting tweakments young is that you don’t actually know what your ageing face would have looked like without them. This could lead to a bit of perception drift – something we explain in more detail in our Tweaktionary.

“With repeated treatments, people can gradually lose perspective on what is normal for their age or what they looked like before treatment,” explains McCarthy. “This can lead to unrealistic expectations of what is normal for their facial structure or appearance as well as the risk of over-treatment.”

Will preventative Botox make your muscles lazy?

As with exercise, any muscle you don’t use atrophies over time – and that’s true for your face too. Muscles that are continuously whacked with toxins will weaken and – while you might not mind that if that means you have less tension from teeth grinding – it could make your facial expressions less expressive over time.

“Botulinum toxin not only reduces movement but, with repeated use, can also reduce muscle bulk,” outlines McCarthy. “If treatment is started too early, this may lead to unwanted changes in facial balance or expression.”

Is preventative Botox bad for our brains?

While many people report starting toxin injections to boost their confidence (and there’s nothing wrong with that), the concept of needing to banish wrinkles before they even appear does rather demonise any sign of ageing as something shameful to be avoided at all costs.

“I feel very strongly about the negative messaging about ageing that younger people receive today and I think preventative Botox feeds into this,” warns McCarthy. “The reality is that ageing is a normal part of life and it is a privilege not afforded to everyone. There is plenty of time later in life to consider Botox if you so wish and it will still be effective. The fear-mongering narrative that “you must begin treatments before wrinkles appear” is misleading and unhelpful!”

Can Botox ‘stop working’?

Finally, there’s the fact that it’s rare, but not unheard of, to become resistant to toxins over time. That means you might end up paying for treatments that become less and less effective, just as other aspects of ageing, such as decreased skin quality really kick in.

It seems to happen more to people who have larger and more regular doses, particularly if those doses are given too close together, and it seems to happen when your body generates antibodies to the proteins that are part of the toxin’s structure. It’s definitely something to speak to your practitioner about if you do still want to give toxins a try.

What is an alternative to preventative Botox?

As we always say here at The Tweakments Guide, a holistic approach to your face and tweakments journey is always best. That includes getting the basics right from a young an age as possible – so skincare really should be your first port of call. After all, “a sensible skin routine with daily SPF 30-50 use has considerably more scientific evidence and considerably cheaper,” concludes McCarthy.

“Ultimately, preventative toxins should be approached with realistic understanding and in conjunction with broader measures such as sun protection, healthy lifestyle practices, and acceptance of the natural ageing process,” agrees Adam.

How to get it right?

Whatever your age, if you do decide to go under the needle, it is always best to have cautious, conservative treatment, just enough to soften your expressions without wiping them out, and don’t have it too often either.  There’s also no law that says you have to have the stuff continuously. The toxins police won’t come and get you if you stop (or start again).

To learn more about wrinkle-relaxing injections, click here.