“Preventative Botox is unethical, it is unsuccessful and it is certainly something I would not want to be associated with.”

Mark Simpson in The Rise and Rise of the Spornosexual once stated that in the visual world, “if you aren’t noticed you just don’t exist” a statement that has now essentially become the rallying cry for the 2018 millennial.

What do I mean? Well, let’s just say that the stigma of ‘having work done’ is quickly diminishing. Cosmetic interventions are definitely becoming the social norm. A statistic last year highlighted that the average millennial takes at least 6 selfies a day and on average, 28,000 selfies in a lifetime. So, it’s not surprising that living their lives through a camera lens has led to a fixation on the way they’re perceived through social media channels.

People as young as 16 are now considering preventative Botox, with surgeons such as Dr Darren McKeown having to turn patients away. McKeown claimed that teenagers are being “mis-sold” on the idea that preventative Botox will help them maintain their youthful complexion. While McKeown has stressed that he personally would not perform it on patients as young as 16, he warns that others in unregulated industries will gladly perform the procedure on very young patients.

Facial Cosmetic Procedures on the Up

In a recent survey, 64% of members (nurses, doctors and medical practitioners) stated that they had seen a drastic increase in patients under the age of 30 opting for facial cosmetic procedures or injectable treatments. The Plastic Surgery Statistics Report for 2016 also reported that over 20,000 patients aged 13-19 had some form of Botox treatment, a 5% increase from 2015.

So, what does this all mean? Is preventative Botox safe? Is it trusted? And does it work?

What is Preventative Botox?

Botox is, as Dr. Alexes Hazen defines it, ‘an attenuated neurotoxin that acts to temporarily paralyze the muscle it is injected into’, the only difference with preventative Botox (also known as prejuvenation) is that it is done before the lines appear. The common age that women choose to have preventative Botox ranges between their early 20s and 30s. Preventative Botox, in essence, has been designed to simply avoid acquiring wrinkles in the first place.

Is It Safe for Young People?

While Botox has basically now become a routine procedure and is obviously FDA-approved for people who are over 18, some specialists are wary over administering it to younger patients. Dr. Mark Holmes of The McIndoe Centre believes that the procedure is both “unethical, unsuccessful and certainly something I would not be associated with.” While there is no known harm in administering preventative Botox on patients as young as 18, surgeons have the right to refuse to operate if they believe it is unethical or the patient is not a suitable candidate for the procedure.

Opposingly, however, Debra Jaliman a New York-based dermatologist gave a conflicting opinion, claiming that “the earlier you start Botox, the better since it is best used as a preventative measure to avoid getting fine lines and wrinkles.”

Similarly, Dr. Elizabeth Hale, the associate professor at New York University stated that one advantage of starting (preventative Botox) early is that “you never let that muscle get so thick and hypertrophied, you’ll never get such a deep furrow and you can do it in less frequent intervals.” The benefits on paper do seem quite appealing, and ultimately, if the procedure is safe, what is the problem?

The controversy lies ethically; is it advisable for patients as young as 18 to undergo Botox procedures when it isn’t a ‘necessity?’

Who is Having this Procedure?

Since 2010, Botox procedures have seen a startling 28% increase and similarly, there has also been a 32% increase in dermal fillers. The youngest people opting for Botox treatments between 2010-2015 were in their late 30s. However, patients as young as 18 years old are considering Botox treatments to ensure that their youthful skin remains that way for as long as possible.

It seems as if Botox is essentially following the same concept as visiting your dentist every 6-8 months to prevent cavities.

Asking an Expert

I was put in touch Consultant Plastic, Cosmetic and Reconstructive Surgeon, Charles Nduka of The McIndoe Centre. Charles is one of the UK’s leading consultants and has performed ground-breaking operations to restore facial paralysis. Here he gives viewpoint on the controversial topic.

Q. Is there any benefit performing prejuvenation at an earlier age?

A. There is very little published scientific data supporting the idea of having procedures before they are required. This would seem to be exploiting people’s fear of getting older. For example, if a young person does not have static wrinkles and is having Botox, there’s clearly a cost implication of repeated treatments and the benefits are minimal at best.

Q. Where do you stand on the concept of prejuvenation?

A. Ethically, I personally think this is practice on shaky ground, and it’s without any proven evidence of effectiveness. There are a couple of specific instances where preventative treatments are warranted but the proportion of such people is very small.

Q. Are there any alternatives to prejuvenation?

A. Maintaining a good diet, applying sunscreen and generally staying healthy will dramatically improve your chances of maintaining healthy skin.

I then went to visit Baljit Dheansa, another highly-respected consultant surgeon, also based at The McIndoe Centre who is internationally renowned for his work in burns and reconstructive surgery. His response echoed that of Charles, stating that preventative Botox is simply “the consequence of a saturated market.” He continued:

“It is essentially the desire of certain providers to increase activity by convincing those who don’t need plastic surgery that they do, and, in turn, make them think they are able to defy the effects of ageing.”
Dr. Mark Holmes similarly evidenced that the alternatives to prejuvenation simply lies in maintaining a healthy lifestyle. “Aging is 20% genetic and 80% environmental. Things like maintaining a healthy lifestyle have the potential to switch-on good or bad genes.”

It seems that while preventative Botox does not appear to include any risks to physical well-being, many leading practitioners are ethically against the concept. There may be small instances where preventative treatments are warranted but these are extremely rare. Younger patients who are seeking-out unregulated preventative Botox treatments must remember that the effects of the procedure are minimal at best and its long-term effectiveness is also questionable.

The Future Looks… Young?

While Botox is more widely available than ever before, the procedure still requires the knowledge and handling of a qualified and experienced expert. Yes, some clinics will offer shockingly low prices for Botox treatment, but don’t be surprised if your expectations do not match your outcome.

Put it this way, if you’re young, low on confidence or your image is severely impacting your quality of life, then arrange to have a chat with a qualified specialist or surgeon to discuss your options. If, however, you’re considering preventative Botox at the age of 18 in pursuit of vanity or because ‘everyone else is doing it’ – it is unlikely that you will be offered treatment.

Of course, there will always be alternatives to Botox. Moisturising, keeping hydrated, applying sun protection when necessary and simply maintaining a healthy lifestyle will always be beneficial. If you are considering Botox of any kind, read reviews, do your research and talk to a qualified specialist before rushing into anything.

Connor

Connor is a medical blogger, covering everything from cosmetic and plastic surgery to dental and orthodontic practices. He has a particular interest in the psychology behind cosmetic surgery and works closely with world-renowned surgeons across the UK.

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