Should I get Botox to prevent wrinkles?

Our frown lines between our eye brows, forehead furrows, and lines around the outer corner of our eyes are due to repetitive folding of the skin from facial expressions.  Day to day, the more you move your facial muscles the more quickly those lines and wrinkles will form.  We know that once these lines form, Botox may be a good idea to keep these areas from having the deep creases that are difficult to remedy, but is it helpful to get Botox to prevent lines and wrinkles from actually forming?

My answer? Yes and no.

I would say YES to you if...

You are someone who "talks with your face." Yeah, you know who you are. Some of us are very expressive when we talk and our face is moving all over the place. These individuals should consider Botox because you will have visible wrinkles much earlier (early to mid 30s) than others your age. As I mentioned above, the more you move your face the more you are subject to the creasing and wear and tear on our collagen and elasticity of our skin.

You look around and you have more fine lines and/or furrows than others your age.  This may indicate you are a "face talker", but genetics also play a part in our facial muscles.  Some individuals have bigger, stronger facial muscles naturally, meaning deeper creases will form faster. Once again, the more you move the facial muscle groups from the first paragraph, the more wrinkles will form.

You get headaches in your face after a long day and your physician hasn't found a good reason why. Yes, facial headaches can be from eye strain, sinus disease, and migraines, but if you aren't found to have any conditions causing headaches, Botox may be something to try. This holds especially true for pain above the eyebrows, which can be caused from having  a "concentrating face" on all day. Typically if you are scowling all day, you will notice lines forming between your eyebrows.

I would say NO to you if...

You are frustrated by the creases around your mouth (smile lines). This is a very common area of frustration that I get asked about, but this is not an area that we treat with Botox.  We do, however, place dermal fillers in your smile lines to smooth the area out, so that is an option if you are looking at treating this area of your face.

You think a flawless face is an entirely wrinkle-free face. The quest for absolutely no wrinkles can result in an unnatural (even scary!) appearance. If your face moves some (which it should) but you are not actually wrinkling your skin, you aren't likely to be causing an increase in lines and wrinkles. Not all movement causes wrinkles, but movements that crease your skin will cause wrinkles over time. The goal of Botox is to give a natural look with less movement so these areas are not subject to the repetitive creasing.

In summary, Botox can be effectively used as a preventative measure to reduce the muscular contractions in our face that cause the creasing and wear and tear wrinkles. Botox has been somewhat of a game-changer in the cosmetic world because it can delay and even prevent the need for certain cosmetic surgeries, but it does not prevent the wrinkles from sun damage. Remember to wear a sunscreen moisturizer daily, even in the winter months.  Botox can be very beneficial to a more youthful look, but don't forget about the other important areas of beautiful skin : even skin tone, the fewest blemishes, clean pores, smooth texture, and small pore size.  These other areas can be achieved by long-term use of a well-formulated skin care product with a retinoid. Topical retinoids along with Botox can address the key areas that we all look for in our quest for the best skin we can possibly have.

--Jean Gustafson, MD
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