What Is Preventive Botox (or ‘Baby Botox’) — and Is It Safe?

With a youthful glow and nary a wrinkle in sight, 23-year-old Allegra Phipps probably isn’t the type of person you’d imagine getting Botox. But she’s not seeking treatment to address existing signs of aging, she says in an Instagram video. Instead, she’s interested in preventing unwanted lines from forming — a procedure known colloquially as “baby Botox.”

Here’s what you need to know about using Botox for prevention, including how it works, where to get it, and what to expect at your first appointment.

There’s no established definition for baby Botox, says a board-certified dermatologist Noëlle Sherber, MD, a clinical associate professor of dermatology at the George Washington University School of Medicine and Health Sciences, and co-founder of the dermatology and plastic surgery practice Sherber+Rad, both in in Washington, D.C.

“If preventive Botox patients have wrinkles at all, they’re dynamic wrinkles (wrinkles that appear when making facial expressions) rather than static wrinkles (wrinkles that appear even when the face is at rest),” Yadav says.

• Forehead lines: 10 to 30 units
• Lips: 2 to 4 units
• Around the lips: 3 to 6 units
• Brow area: 2 to 5 units

“With that being said, individuals respond differently, so someone might need more or fewer units,” Dr. Sherber says.

However, she says that it can vary depending on factors such as muscle strength, movement habits, and a patient’s goals. “It may be that, for prevention, treatment every six to eight months is enough to keep the muscle relaxed,” Dr. Gmyrek adds.

“It’s like folding, unfolding, and refolding a piece of paper ad nauseam. After a certain point, those wrinkles are ingrained in the paper,” she says. If you couldn’t fold the paper, those wrinkles wouldn’t appear, Yadav says.

Preventive Botox doesn’t necessarily stop wrinkles from ever forming, but it may help slow their development and decrease their depth and severity, says Samuel Bartholomew, MD, a board-certified plastic and reconstructive surgeon in Portland, Oregon. “It’s like getting ahead of the problem by nipping wrinkles in the bud,” he says.

Experts agree that, while the benefits of preventive Botox are evident in their clinical practices, research is limited and mostly involves smaller, observational studies.

“I’d rate the current evidence as promising but not yet conclusive,” Gmyrek says. More long-term, controlled studies will help determine the treatment’s potential, she adds.

But don’t be fooled by the cutesy name — baby Botox, like any medical procedure, carries some potential risks. Side effects and complications may include:

• Pain, bruising, or swelling in the treated area
• Droopy eyelids
• Crooked eyebrows
• A crooked smile
• Drooling
• Headache
• Flu-like symptoms
• Dry or watery eyes
• Infection at the injection site

However, some — such as muscle atrophy — may have lasting effects.

When this happens, other muscles may take over for those that aren’t in use, Bartholomew says. For example, overtreating the forehead could cause the eyebrows to be drawn down, and other facial areas may begin to contract and make unusual expressions, he says.

“Those seeking preventive neurotoxin treatment can limit treatment to once or twice a year if they’re concerned about this, but it’s not something that comes up much in my practice,” she says.

“While Botox is common in self-care routines, it remains a medical procedure — not just a beauty treatment,” she says.

You may also need to avoid Botox if you have:

• A neuromuscular disease such as myasthenia gravis

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• Weak facial muscles

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• Drooping eyelids (ptosis)

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• Infection or inflammation at the injection site

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• An immune-system disorder

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• A known allergy to the medication or its ingredients

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It’s crucial to tell your healthcare provider about any medications you’re taking before treatment, he says.

“I recommend seeing board-certified dermatologists or facial plastic surgeons for treatment, as they have an intimate understanding of facial musculature and how to best treat them with neurotoxins,” Yadav says.

“Most providers charge by the unit, therefore making smaller-dosage treatments more affordable,” says Gina Maccarone, MD, a board-certified cosmetic surgeon and founder of The Surgeonista in Cincinnati, Ohio.

With that in mind, Dr. Maccarone says you may end up spending more in the long run, as you’ll receive more total treatments. “It would seem that starting the treatments earlier would lead to more money being spent, but better long-term results.”

You likely won’t need any downtime, but aftercare is important. Todd says instructions usually include the following:

• Stay upright for at least four hours.

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• Don’t rub or apply pressure to the treated area for at least 12 hours.

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• Avoid strenuous workouts and anything else that increases your heart rate and blood flow.

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• Refrain from drinking alcohol and taking NSAIDs (nonsteroidal anti-inflammatory drugs), such as aspirin and ibuprofen (Advil), the day of your procedure. These may increase blood pressure and bruising.

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• Don’t use retinol for at least two days.

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“Consistency is key. Preventive Botox works best when maintained over time,” Todd says. It’s also important to understand the treatment’s limitations, she adds. “Combining Botox with other measures — including good skin-care and a healthy lifestyle [such as wearing sunscreen] — can enhance the results.”

• It’s impossible to stop aging altogether, but preventive Botox — alongside healthy lifestyle habits such as wearing sunscreen and following a good skin-care routine — may help younger adults maintain a youthful look for longer.
• While there’s extensive research on Botox and similar cosmetic injectables, studies on preventive Botox, specifically, are limited. Although research thus far suggests the treatment may be beneficial, more robust, long-term studies are needed.
• Botox is generally safe and well-tolerated, but side effects and complications can occur. And the treatment isn’t appropriate for everyone, including those who are pregnant or have certain neuromuscular disorders.
• It’s crucial to only get FDA-approved injectables from a licensed, qualified professional to reduce the risk of undesirable results and potentially serious harm. It’s also important to follow preparation and aftercare instructions.