Young people are turning to botulinum toxin, fillers, peels and more to prevent signs of aging. But are they doing it for legitimate reasons or simply succumbing to marketing messaging and perceived pressure?
The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) released news earlier this year that millennials are in the spotlight for their desire of “prejuvenation,” a term some use to describe patients who begin noninvasive beauty treatments sooner to prevent rather than later to correct the signs of aging.
Nearly three-quarters of facial plastic surgeons report seeing an increase in patients younger than 30, according to the 2018 AAFPRS annual member survey.
But does treating 20- and 30-year-olds really prevent aging? And is it safe?
Sabrina Fabi, M.D., a dermatologist in San Diego, says it’s more about treating the signs of aging that are actually occurring than it is about “prejuventating.”
“We start losing bone at age 25 and that bone loss becomes significant by 35. The reason people start to notice wrinkles — even though they’ve been frowning, laughing and lifting their foreheads all their lives — is because now every time they do that, the muscle doesn’t have bone to relax back onto. If you relax those muscles, then you’re able to minimize the appearance of lines and wrinkles,” Dr. Fabi says. “So, treating a 20- or 30-year-old is not inappropriate because they are already exhibiting the pathophysiologic signs of aging. It’s not that you’re pre-rejuvenating them, you’re treating them.”
There is evidence to suggest treating facial muscles that create significant lines with movement early might help people look younger as they age, according to Dr. Fabi, who was among the authors of a long-term study looking at patients whose glabellar lines were treated with onabotulinumtoxinA injections for an average 9.1 years.1
“Among the 89.7% of patients who reported looking younger, the mean perceived age was 6.9 years younger,” according to the paper.
Prejuvenation is a term that’s being used for younger patients looking to prevent sun spots, wrinkles and skin sagging, according to dermatologist Noelani González, M.D., director of Cosmetic Dermatology-Mount Sinai West.
“We are seeing a trend where these services are being marketed to younger patients, starting with skincare including sun protection, antioxidants and retinoids, and ranging to the early use of neuromodulators, fillers and fractional resurfacing in their late 20s to early 30s, such as the non-ablative fractional resurfacing Clear and Brilliant [Solta Medical] laser, which is a favorite of mine for younger patients looking to improve their skin's texture, tone and give it an overall nice glow,” Dr. González says.
Drs. González, Langsdon and Zeichner report no relevant disclosurfes. Dr. Fabi is a consultant, speaker, trainer and investigator for Allergan, Galderma, Merz, Valeant, Revance, Evolus and other companies.
1. Trindade de almeida A, Carruthers J, Cox SE, Goldman MP, Wheeler S, Gallagher CJ. Patient satisfaction and safety with aesthetic onabotulinumtoxinA after at least 5 years: a retrospective cross-sectional analysis of 4,402 glabellar treatments. Dermatol Surg. 2015;41 Suppl 1:S19-28.
2. Rivkin A, Binder WJ. Long-term effects of onabotulinumtoxinA on facial lines: a 19-year experience of identical twins. Dermatol Surg. 2015;41 Suppl 1:S64-6.
3. 1. Bonati L, Fabi S. Treating the Young Aesthetic Patient: Evidence-Based Recommendations. J Drugs Dermatol. 2017;16(6 Suppl):s81-83.