The Logical Extreme Of Anti-aging

Something weird is happening on my Instagram feed. Between posts of celebrities with perfect skin are pictures of regular people—my own friends!—looking just as good. They’re in their mid-30s, yet their faces look so smooth, so taut and placid, that they look a full decade younger. Is it makeup? Serums? Supplements? Sleep? When I finally inquired as to how they’d pulled it off, they gladly offered an explanation: “baby Botox.”

Like normal Botox, baby Botox involves injections of a muscle paralytic. The difference is that baby Botox is proactive versus reactive: If first administered in youth and repeated every few months for the rest of your life, baby Botox can prevent wrinkles from ever forming. It’s referred to as “baby” because the process uses smaller doses than normal, resulting in a relatively natural-looking effect versus the “frozen” look associated with Botox, and usually the people who get it are young—not literally babies, but sometimes still teenagers.

Baby botox is hardly a new procedure: As a college student in 2008, I worked part-time as an assistant to a doctor who specialized in cosmetic injectables. Occasionally, middle-aged patients brought in their daughters, who were around my age, for baby Botox. But recently, the procedure has become more mainstream. The number of 20-somethings who got Botox and similar injectables jumped 71 percent from 2019 to 2022, according to the American Society of Plastic Surgeons. The procedure is especially popular among Millennial and Gen Z women who live in major cities and have some extra cash; each session runs hundreds of dollars. (Though you can find medical spas that offer baby Botox in Scottsboro, Alabama; Fishers, Indiana; and Lincoln, Nebraska.) I know enough people who have gotten the procedure that I’m starting to wonder if my own skincare routine—cleansing regularly, moisturizing, and slathering on sunscreen—hasn’t been enough. At 37, I’ve noticed a few creases on my face: laugh lines that never disappear, a fold in my under-eye bags that, tragically, makes me look twice as tired.

The goal of baby Botox is the same as everything else in skincare: to slow the signs of aging. Ancient Egyptians used fenugreek and ladanum to treat wrinkles. In 500 B.C.E., Chinese women used tea oil and rice powder to hide their fine lines. These days, a staggering range of creams, serums, masks, and peels exist for the same purpose. People are obsessed with skincare, and they’re starting it earlier than ever before: This is the era of the Sephora tweens, Gen Alpha children obsessed with anti-aging products meant for their mothers. Baby Botox is the culmination of all of these impulses, taken to their logical extreme. It isn’t just an attempt to slow the signs of aging; it’s meant to stop them altogether.

Any face that moves will form wrinkles eventually. So-called dynamic wrinkles appear only when the face is in motion, but with enough repetition and time, they eventually form static ones, which persist even when the face is at rest, Helen He, a dermatologist at the Icahn School of Medicine at Mount Sinai, told me. Since Botox was first approved as a treatment, in 1989, it has largely been used to soften the appearance of dynamic wrinkles. (It can’t do much about the static ones.)

Baby Botox, by contrast, endeavors to prevent static wrinkles from ever appearing. Though good long-term studies of its effects on appearance over many decades are lacking, by and large, the procedure seems to work. “If you start doing Botox a little earlier in life, you’re going to prevent the wrinkles from coming out in the first place,” Raman Madan, a dermatologist with Northwell Health, in New York, told me. After a decade of treatment, their skin may look as tight and bouncy as it was at the start. Foreheads and cheeks are mobile but serene, like calm waters.

There is, of course, a catch. Just like the conventional version, the effects of baby Botox usually wear off after three to four months, He said. Without a new round of injections, the effects fade; as muscles regain more movement, expressions ripple across the face, with all their wrinkle-forming force. To get the intended result, you have to commit. “It is something that you have to continue throughout your lifetime,” Madan said.

Not that sticking with baby Botox allows someone to never age. It can’t prevent sun damage, preserve the skin’s elasticity, or stem skin sagging because of declining collagen. Although it has proved to be quite safe, a potential hazard is that, over many decades of use, facial muscles may atrophy, which could lead to a more aged appearance, He said. Occasionally, the face, determined to emote, recruits other muscles to compensate for immobilized ones, which could lead to wrinkles in unexpected areas, such as “bunny lines” around the nose. The skill of whoever is injecting the Botox makes all the difference; experienced technicians should be able to anticipate future movement. But again, patients stop treatment at their own peril: Faces begin to wrinkle as soon as the effects fade.

Injecting your face with a muscle paralytic three times a year from your early 20s (or even late teens) onward seems like an enormous undertaking, financially and otherwise. Botox averages $435 a treatment; even with smaller doses, the costs add up. Yet many justify the expense; it is, after all, far cheaper than more invasive cosmetic procedures, such as surgery and laser treatments. And an injection is a better bet than an $80 anti-aging cream that may not work.

The rise of baby Botox has been driven by the usual suspects, He said: selfies, social media, and celebrities, which not only advertise the effects of Botox (baby or otherwise) but also lessen the stigma. Several baby-Botox patients I spoke with—women in their mid-30s who began treatment in their late 20s—said that The Real Housewives and Vanderpump Rules, which star reality-TV personalities whose Botox journeys could be tracked by the episode, influenced their decision to start.

But people are getting Botox even earlier in life. The number of Americans ages 19 and under who got injections of Botox or similar products rose 75 percent from 2019 and 2022—and then rose again in 2023. “There’s no age that’s too early,” Madan said; he clarified, however, that treating a teenager wouldn’t be appropriate. According to He, teens and people in their early 20s simply won’t benefit from Botox: Their skin is still so collagen-rich that it won’t form wrinkles no matter how much it moves. That doesn’t stop some people from administering it. In England, anyone under 18 can’t legally get Botox, so teens travel to Wales, where the laws are less strict.

Despite the treatment’s drawbacks, a person who starts baby Botox at 25 and keeps it up could still look that age a decade later. In another 10 years, they may look noticeably young for their age. Even if they stop at that point, they age on a 20-year delay. “Will you look 20 when you’re 60? No,” but you will definitely look younger, Madan said.

Baby botox is the pinnacle—or nadir—of anti-aging. The obsession with staying young consumes adults and youth alike, and never before have such effective anti-aging tools been so appealing or accessible. “Personal care’s creep into younger demographics” is fueled by enterprising companies, skincare-obsessed Millennial parents, and TikTok beauty influencers, Elise Hu wrote in The Atlantic. That baby Botox is only getting more popular among younger people is to be expected. When I asked Dana Berkowitz, a sociologist at Louisiana State University and the author of Botox Nation: Changing the Face of America, whether baby Botox would ever become the norm, she told me, “There’s no if—it’s when.”

Nearly all of the baby-Botox patients I spoke with said they planned to continue indefinitely, marveling at its ability to make them look “hot,” “tight,” and “snatched,” internet-speak for a certain lifted, foxlike aesthetic. Yet they also acknowledged feeling coerced into the pursuit of agelessness. For many people, especially women, taking steps against aging feels like a duty. “Women are stuck between a rock and hard place: If you don’t, you’re chastised for letting yourself go, if you do, you’re vain and frivolous,” Berkowitz said.

As baby Botox takes the ability to slow aging to new heights, it changes what it means to get old. Looking “good for your age” has already shifted with improvements in skincare and lifestyle—people no doubt aged faster before indoor jobs and sunscreen. Before learning of my friends’ Botox regimes, I thought I looked good for my late 30s. Now I’m not so sure. It used to be enough to have a youthful appearance, but the norm is moving toward looking like you have not aged at all.

Baby Botox may prolong the semblance of youth, but perhaps looking young forever won’t be as great as it seems. No matter how the norms shift, looking young can only take you so far. When I was 21, a much older person told me that I could have a career as a news anchor—but only once my naive face had “gained some gravitas.” Looking in the mirror now, a part of me thinks I’m finally getting there.