Injectables through the ages
How young is “too young” to start injectable treatments for the face? When are you “too old” to stop benefitting from injectables? These are common questions asked all over the internet and in every facial plastic surgeons office on a daily basis! The truth is, if you have concerns about how you are aging, or the impression your face is giving when you look in the mirror, it never hurts to seek an experienced opinion on your options. A good Facial Plastic surgeon will be able to give you a range of options after asking about your overall comfort level. And don’t despair if surgery is discussed within that range, even though you were hoping for a nonsurgical option. Often, I will include or at least discuss a surgical option if I think it is beneficial. That is the purpose of seeking an expert’s opinion: if you would benefit more from a particular option, it is within my duty to inform you of that so your very best results are achieved!
As far as clear-cut age cutoffs, they rarely exist. I have not treated anyone under the age of 25 with injectables cosmetic purposes (some younger patients require them for medical reasons, of course), but have treated patients all the way up to 85 with both fillers and Botox© for all sorts of concerns!
Let’s start with Botox© since it is the most popular nonsurgical intervention in the US. Botox can be very helpful even at an early age (late 20s up to mid-30s) both to prevent and treat the finer lines that come with repeated contraction of facial muscles. These are often seen between the eyebrows and the forehead but can also be seen around the mouth or eyes.
If you are someone who has always frowned or made deep lines when expressing, you may feel as though these lines have formed earlier in your face than in others, and you may feel they give the impression of looking angry or tired all the time. If these lines are present even when you are at rest, it may be time to consider treatment. As I said earlier, Botox can be useful to prevent these lines as well. If you constantly make these expressions and want to prevent the formation of new lines, this treatment can be helpful to keep future lines and wrinkles at bay. That being said, we don’t want to prevent all aging, so our goal will always be to maintain a natural, but refreshed appearance. Often, in a younger patient, treatment with Botox© will only be required 2-3 times a year to maintain results.
As we age, (40s-60s,) Botox© may be needed more frequently. Even if you are at this age and have never tried Botox©, it can be a very useful treatment both for existing lines as well as prevention of deeper creases. The most frequent age range to seek intervention is often within this group. Patients may require treatment 4-5 times a year, but often with consistent treatment, deep lines fade to finer lines, and fine lines may disappear completely! Botox can accomplish a lot with a few injections: subtle lifting of the brows, opening of the space between the eyebrows and making you look more refreshed and brighter in expression.
With other injectables the range of options dramatically increases. I have treated patients in their early to mid-20s with fillers mostly in the lip area (Juvederm© or Restylane©). Trends change frequently, and the current one is for fullness in the lips. Younger patients often present interested in increased fullness, but I often temper that fullness to a more conservative and natural result. As we age, (40s and above,) our lips tend to lose volume just as other parts of the face, and it is an often overlooked opportunity for youthfulness. Patients in this age group are fearful, understandably, of an “overdone” look similar to those seen in the tabloids. However, adding a very small amount of definition and “bee-stung” appearance goes a long way to establishing a more youthful appearance. Performed under topical anesthetic and lasting 4 months or more, a slight increase in fullness of the lips can be very attractive in this age group.
Other facial injectables that are common in all age groups are fillers under the eyes (Restylane© being the most often used here). Hollowing can increase with time and age as well, but patients in a wide range of ages will present concerned about “dark circles” making them appear more tired than they feel. It is important to understand that when the color of the skin is darker itself, fillers may not be helpful. However, if a patient has lost volume under the eyes and there is darkening because of a shadowing effect, fillers may be very useful in improving the appearance of this area.
Finally, patients usually in their mid to late 40s and above can often benefit greatly from added volume and lifting in the mid-face region. Fillers such as Juvederm Ultra Plus© and Voluma© can be used to lift and subtlely repositioning drooping cheeks to decrease the appearance of lines around the mouth and also decrease early jowls! These types of fillers pull double duty as the process of injecting them also stimulates some collagen production. Meaning that with time, you can be left with slightly more collagen in your tissues than before you had the injections. If you continue to get them, you may even need less product and less often which is an added benefit to your wallet!
As you can see, the range of options and the ages at which you can benefit most from them varies greatly based on a patient’s desires, anatomy and recovery periods. Once you have investigated your options and need some guidance, a Facial Plastic surgeon can be a critical next step. A consultation with a surgeon can clarify what your desires will translate to and what, if any, other options exist that you may not have known about. Make sure you ask how many times your surgeon has performed these procedures, what kinds of risks or side effects he or she commonly sees and what can be done about any expected complications. You will quickly learn the world of injectables is an exciting one that can bring years of youthfulness back to your face with minimal downtime and maximum reward!
