Am I too young/too old for botox? When’s the best time to start using toxins?

For those familiar with botulinum toxins (botox for ease), they are usually fans of it. For a lot of others, it feels really scary and has a sense of ‘once you start, you can never stop’. So, what is the real deal with botox? Is there a ‘perfect’ age to start? Should you even start it at all? Is there a point when you should stop? Can you ever stop once you start? The questions go on and I will try to answer some of them.


For transparency, I will let you in on a little admission: I use botox for myself and have been doing it for a few years now. I like things really natural so a lot of people find it hard to tell that I’ve had any (although if you’re really good, you might be able to tell). I started in my late 30s and now am in my 40s. So my opinions are real- based on my personal and my patient’s experiences- but I may be a bit biased as I do love botox!


The best age to start botox

Whilst its commendable to go around claiming that botox should not be done below or above a certain age, it simply is not as simple as that. When one takes into account genetic ageing, sun damage, environmental & toxin exposure, stress, it completely changes the way one ages. You could easily have a set of twins, one decides to stay in the countryside, marries her childhood sweetheart, has a relatively happy life. The other twin decided to find her fortune in the city, has the time of her life but with a lifestyle that involves heavy partying, holidays abroad etc. Let’s just say both are about 7/10 of the happiness scale. Who do you think will have more signs of ageing? My point is that age is relative. Its more about what it is doing to your confidence, if your lines concern you and if you have realistic expectations.


My opinion on ‘preventive’ botox

Every so often, I get asked to do botox as a preventive measure. There are generally 3 kinds of requests that go along with this.

  1. Someone with existing wrinkles who don’t want things to get any worse.

  2. Someone with no obvious wrinkles but are very aware of what the future holds!

  3. Someone who doesn’t want lines when they speak.

1 is nice and simple and forms the majority of people wanting botox. Botox works well and they will find that after a year, their lines appear much softer, even if they don’t continue with botox.

2 is a bit on the fence. I personally don’t think its a good idea to start that early. The reason is because too many years of botox use, especially on normal sized muscles will cause atrophy (when muscles go very flat due to disuse) and that’s when you get that flat, shiny forehead. So I’d wait a bit here.

3 feels similar to 2 to me and frankly makes me a bit sad. Why wouldn’t someone want to show expression? Thankfully, this is quite rare especially now that having facial expressions is back in - I think Hollywood finally caught on!


How old is too old?


I personally think that there’s a place for botox at any age over 45. Just don’t make the mistake of doing too much as it can then look artificial i.e. parts of your face is smooth and other parts crepey and wrinkled. Your practitioner should advise you on a resulting look which will work with the rest of your face. In the right hands, if a more holistic approach is undertaken, a combination of different therapies like filler, mesotherapy, radiofrequency etc can shave years off, but in a very natural way. No need for facelifts!

Can you stop botox once you've started on this journey? Of course. You have to not mind a bit of expression though, which I find a lot of people tend to prefer with age anyways.

As an end note, look at lots of pictures, talk to lots of people, read blogs and forums and get an ethical practitioner.

How to Avoid FROZEN.... (Face, I mean) or How To Get The Best Out Of Your Botox Consultation

When botulinum toxin (I’ll call it botox for ease) first came onto the aesthetic market, there was initially a lot of trial and error as to what constituted the best result. The most common ‘desired’ outcome was not to have any lines at all. This required a larger quantity of botox and/or for it to be done more frequently. This resulted in the ‘botox look’- a clear shiny forehead, slight Spock-ish eyebrows and a same-ish expression.

Whilst some people still like this look, most have started shying away from this and prefer a balance where there still is some expression, but the lines appear softer. Unfortunately, most current day training for practitioners in the UK (in my experience at least) is still old school. Its then up to the practitioners to figure it out and help their patients to find the right balance.

This is reflected in my practical experience as well, where quite a few of my patients come to me after being ‘frozen’ and asking for their results to not be too obvious.


So how can you get the best out a consultation with your practitioner?


  • Before even going to your doctor, ask yourself what it is you want to achieve. The number of times I’ve had patients confuse botox and fillers is quite high. I also get people who don’t really know what they want.
  • Look at magazines and other people’s expressions when they talk. See if you can get someone to record you when you’re having a conversation and study your face in motion. Botox is best used for lines in motion or dynamic lines. It doesn’t work as well for lines that are present when the face is at rest, although this could improve over time
  • If you prefer a natural look with some movement, accept that you’ll have to get botox done more frequently but with a lesser amount each time. Some places also offer ‘baby botox’ which is basically a smaller amount of botox used in a few areas- great as a taster but works equally well if that’s your preferred look.
  • Its generally better to undertreat for your first session with a new practitioner. Most reputable places will offer free top ups.
  • If your treatment doesn’t go to plan ie you still have a lot of movement, do go back to see your doctor. Most things can be corrected and your doctor should adjust the treatment and fine tune things. This will be especially helpful for your next session as your treatment notes will remind your doctor of what your personal preferences are and how you personally react to botox.
  • Most practitioners will use a standard quantity in each area. Depending on the individual, this could be too strong or too weak. Do remember that one size does not fit all. Accept that occasionally it will take a bit of tweaking to get exactly what you want with the same practitioner.
  • As time goes on, your muscles get weaker. This changes how much botox you need or want. Your practitioner should change management accordingly.
  • Do take note of facial asymmetry. Most people have uneven faces and botox can frequently balance things out. However, you may feel like you notice the assymetry more after treatment, despite the fact that it may have improved. This is usually due to people paying to attention to their faces post procedure. With good ‘before’ pictures, this won’t be a problem.

I hope this gives you an idea of what to expect and ask when you go for your appointment. Do remember, its a two way street and it helps if you have done some homework. Do feel free to post questions. I will be posting more blogs on botox soon.