I'm 24 – should I be thinking about 'preventative' Botox?

I thought it was just influencers who used Botox in their twenties to stave off aging – then my friends started doing it and espousing the benefits. Should I jump on the bandwagon? By Emma Hildesley.

I was having a catch-up with a 21-year-old friend, when I casually asked about her skincare routine. I was hoping for advice on an effective cleanser or maybe a cheap but non-greasy moisturiser.

"No girl," she whispered conspiratorially. "I get Botox injections in my forehead."

It felt like a punch in the gut. "What?" I gasped. "But you don't even have wrinkles yet!"

"Yeah - that's the point," she said.

Until that moment I’d had no idea Botox was something people my age even considered, let alone followed through with. Suddenly, like a reverse film reel, I reviewed all the times I'd internally compared myself to this friend, or gazed at her crease-less forehead and wished for better genes before concluding, “ah well, nothing I can do". I was so naïve!

As a woman in my mid-20s, of course I've been targeted by multiple advertising campaigns aiming to capitalise on the seemingly endless list of bodily insecurities that plague my generation. At times, it feels like these big beauty organisations, fronted by glossy-visaged influencers, just invent problems for me to care about.

To a certain extent I’ve been immune to the TikTok trends: "glass skin" one week, "dolphin skin" the next, even the dubiously desirable "glazed doughnut skin". All of them more or less denote the same thing: pretty faces completely free from texture in the form of blemishes or pores.

But wrinkles? Were we even worrying about that at our age? My friend’s Botox revelation felt like learning about a secret underground party to which everyone else got an invitation. I didn't actually want to attend the party (did I?) but it would have been nice to know about it. How did I miss this?

My friend then shared with me a bit more about the "Baby Botox" trend she’d learned about online. Basically young people are getting small amounts of Botox designed not to reduce wrinkles but to prevent them ever forming in the first place. The ultimate, in other words, in that old chestnut: “age prevention”. No doubt that claim goes back decades when it comes to skin creams, but Botox aimed at under-25s is relatively new.

Since that day, I've had frank conversations with others in their mid-20s as to whether they had dipped a toe into the tempting pool of eternal youth via a cold faceful of fluid. The best insights came from one of my old high school friends, Leo Piuza, who shared that his foray into Botox didn't initially stem from a desire to be wrinkle free, but instead to make his face more symmetrical.

"My issue was I used to play the trumpet for years on the right side of my mouth, and because of that I always found that one side of my masseter jaw muscle was way bigger than the other. I basically got Botox just to kind of even it out, and then I started to see that my face slimmed down and I liked the shape of it, so I got the other side done as well.” The “face-slimming” effect of Botox is due to the treatment reducing the size of the masseter muscle, which connects the jaw and cheek bones.

But while being wrinkle-free might not have led Piuza to Botox, he does get injections in his forehead too, to deal with "frown lines".

Piuza says part of his reasoning is that, in his job as a hairdresser, he is constantly looking in a mirror all day, every-day, at clients and at himself. "For me it wasn't necessarily part of the trend of 'oh, I feel like I need to have no wrinkles’... But once I started getting Botox in my jaw, I started to notice that I frown a lot with my concentration face, so I decided to start getting Botox in my frowning muscles as well as my masseters."

He said from that point, it "does become quite addictive" despite the $400 - $500 price tag per treatment. And that’s a few times each year. "For my jaw I do go back every four months just to keep my face nice and slim,” says Piuza. "I think people are more open to sharing about it now. It's not as big as, like going under the knife or anything, it's just a needle."

According to Piuza, it’s not just 20-somethings joining the “Baby Botox” trend, but teenagers as well. "I have some clients who get Botox and they're 19. I'm like, 'girl what are you doing?' because they don't need it." And it's not just Botox, he points out but other injectables and treatments such as lip fillers.

We chat about why younger people feel such pressures and stumble upon the same culprit: Social. Goddamn. Media.

Piuza points out that the images young people scroll through aren’t necessarily accurate depictions of real faces. "You see what goes on Instagram, but they could have taken 100 photos before [choosing that one] and there's so many apps now that can change your face completely."

Piuza says using Botox to narrow the face, as he does, is popular among the Asian community. “Many Asian people don't want that square jaw line which is what we're born with,” he says. "Western cultures use Botox for more anti-wrinkle stuff like that, but in Asian culture, we also use that to kind of slim down on the jawline to get more of that 'V' shaped face."

I appreciated Piuza's candour during our robust and thorough dissection of the Botox topic, because it opened my eyes to a world of cultural differences around cosmetic appearances that I hadn't even considered as a Pākehā person – and one who grew up in a household where natural was our normal.

My beautiful mum doesn’t dye her hair, has never undergone any cosmetic procedures and rarely even wears makeup. And now as a young adult I’ve chosen not to do those things either. Perhaps I've never felt pressure to change much about my appearance because of what was modelled to me in my own home during formative years.

I look up to my mum who continues to age gracefully without any "tweakments" – and those are the decisions I hope to make as well – I just didn’t think I’d be confronted with them quite this early in my life. But even if I was inclined to take expensive steps to prevent the aging process, I’m not sure a shot of Botox would be the solution. Dr Ken Ip, a consultant medical and surgical dermatologist at Auckland City Hospital, says young people using neuromodulators in a "preventative" way simply doesn't make sense.

"They can, of course, be used for good reasons such as controlling severe migraines, refractory hyperhidrosis, or rebalancing facial musculature after injury in young people," he says. But, in Ip’s opinion, using cosmetic injectables for no other reason than to prevent wrinkles is "wrong at every level" and also poses numerous medical risks.

"You could paralyse a muscle you might require in the future, you could lose expression and start to look odd and unusual, you could develop neutralising antibodies or allergies [and] your skin could become hot, dry and uncomfortable."

He also firmly believes that "preventative” Botox is a big ol' waste of money as the impacts of ageing come for us all and cannot be prevented.

This leaves me in two minds about the whole thing. Because while I accept Dr Ip’s summation of both the risks and futility of preventative Botox, I’ve also seen Botox make a visible difference to friends, and I deeply support the right of each person to choose what they want to do with their body.

The risks of Botox apply to all age groups and are relatively rare or short-lived. If a Botox injection helps someone feel beautiful and confident in their own skin, and they’re prepared to pay for it, then why shouldn't they do it?

Everyone has their own confidence-boosters, that don’t necessarily make scientific, financial or logical sense. For instance, though I don’t wear makeup, I love having my nails done because it makes me feel feminine and just a bit more put together. Am I ingesting chemicals every time I layer on another coat of nail varnish? Definitely. Will I do it anyway? Probably. It's about how it makes me feel and it's not up to anyone else to judge.

I don't write from any kind of "natural" moral high ground, after all I'm still a young woman who cares about what others think of me. I also spend a lot of time online where I'm constantly exposed to the idea that a jab of Botox will make me instantly more beautiful. I haven't reached that cool phase of life where I'm genuinely comfortable in my own skin but - like most of us - I'm working on it.

For now I'll stick to the SPF, enjoy being young, and let myself learn, grow and potentially change my mind in the future. With age comes wisdom, right? And at this point I'm happy to notch up some smile lines with it.

Emma Hildesley is a digital reporter at 1news.co.nz.