Dr. Bonakdar Discusses When You Should Start Getting Botox


Ever since Botox cosmetic was approved in 2002 to treat the expression lines in men and women 65 years and younger, there has been a paradigm shift among those interested in looking younger to start their Botox treatments at a younger age.

My practice is no longer limited to clients who want their etched in expression lines fixed. Now a days, I see just as many younger clients who are serious about preventing the many signs of aging from ever starting up.

So I find that the question has changed from do you think I should do Botox to get rid of my wrinkles,  to when do you think  I should start Botox to never get etched in wrinkles.

A recent JAMA Dermatology article states that it is “rarely too early” to start the “conservative and thoughtful use of neuromodulators [i.e., Botox], fillers and noninvasive energy-based treatments.”

Prevention of wrinkles takes quarterly Botox treatments. Whereas repair of wrinkles takes Botox and fillers in a set of 1 to 3 staged treatments and followed by quarterly Botox and yearly fillers. It’s much easier to prevent permanent static wrinkles with early use of Botox than to repair them.

One size does not fit all when it comes to the right time to start Botox treatments and it depends on your risk of developing future static lines. This risk is based on 3 main factors. Your genetics, your expressions and your lifestyle.

Here are the forehead photos of a father and his 24 your old and 17 year old sons. The father has deep static forehead lines.  Years of expressing his strong forehead muscles and folding the skin have resulted in loss of collagen in the folds and the deep wrinkles. Both boys are genetically prone to form their father’s wrinkles. The 24 year old son has started preventative Botox treatments and has no lines whereas the 17 year old son already has an etched in line on his forehead! Genetics plays a role in your wrinkle capacity as do your expressions!

Not every 17 year old has etched in lines. If you are not particularly expressive and you look like you have your poker face on all the time, then chances are you are not prone to wrinkle prematurely. Lastly, environmental factors such as sun exposure and smoking exposure tends to increase the risk of wrinkle formation.

I have clients who absolutely need to start their preventative Botox treatments in their 20’s and 30’s and I have clients in their 40’s who are just starting Botox and they don’t have any etched lines yet. As it is with so many beauty related issues, prevention is key when it comes to Botox.