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Today, let's discuss: Are you aging intentionally with treatments like Botox, Dysport, and more? What have you tried and hated — and what treatments do you love? What age did you start?
Psst: In other posts we’ve talked about other non-invasive procedures like laser hair removal, microblading (a guest poster), and making time for frequent doctors’ appointments — we’ve also talked plastic surgery such as rhinoplasty, breast reductions, and plastic surgery and corporate women in general.
Thinking about Aging Intentionally with Botox
I've seen two articles recently that got me thinking about this — the first was a recent one in The Wall Street Journal. The article started with an anecdote about Dr. Heidi Waldorf, a dermatologist who, every year, posts a photo of herself on Instagram and reviews what treatments she's had done. (Here's her account on IG.)
As they note in the article:
Dr. Waldorf, who began such treatments around 35, was an early adopter of what you might call “intentional aging.” Adherents to this growing trend get their faces improved by dermatologists with low-intervention treatments such as lasers (for hyperpigmentations, wrinkles and scars), ultrasound (for firming), microneedling (for improved texture) and moderate injectables instead of chasing eternal youth via extreme measures like plastic surgery.
The desire for less-intense procedures marks a shift in the aesthetics of aging. In the past, women were more liable to ask for the works: face-lifts, aggressive resurfacing lasers or an excess of filler.
My Botox Intentions
Based on reader conversations here, I've always kind of intended to get Botox starting in my mid-30s… but it's been a low priority, especially since all my extra weight keeps my facial skin nice and plump. (I keep meaning to go through photos of my mother and grandmother to see if there were any major change in their faces at any point; we all have similarly round faces with plump cheeks (three cheers for my Polish ancestry).
(My dermatologist and I have discussed a filler for my marionette lines (most likely Juvéderm) but, well, I haven't gotten around to researching it yet… so I'd love any stories you guys have!)
But this, of course, gets to the idea of the “prejuvenation” — that you should get the treatments before you need them so the skin stays plump, rather than trying to plump up skin that has sagged.
Prejuvenation and Preventative Botox
There was another recent article in The New York Times about this prejuvenation trend where they talked to more than a dozen experts to find out whether “preventative Botox” is a wise investment. The bottom line was that you're delaying wrinkles (not preventing them), and yes, it can work.
The big problem they noted was the idea of using Botox for decades — there hasn't been a lot of study done on this, just anecdata — as well as the cost of paying for relatively expensive treatments for decades.
The part that stuck with me about the article was the discussion of whether you can stop getting Botox:
You’re not going to reverse your progress if you stop treatment — you’ll just get your full mobility back, slowly creating wrinkles.
The effect of pausing treatment is hard to track, though, since few people stop injections once they begin. Even though botulinum toxin itself does not form chemical dependence, many people become “addicted” to how their face looks, said Dana Berkowitz, an associate professor of sociology at Louisiana State University. …
Your face without Botox “looks ugly to you,” Dr. Berkowitz said, adding, “This wrinkle-free, ageless face becomes totally normalized. We expect it and then we view that as beautiful.”
Readers, let's hear from you — are you aging intentionally with treatments like Botox, Dysport, and more? What have you tried and hated — and what treatments do you love? What age did you start, and how consistent have you been? How much are you paying per treatment, and how did you find a provider you like?
Stock photo via Stencil.
anon
I’ll admit it: This sounds exhausting and never-ending, and I don’t want to participate. Maybe I’ll end up looking worse than my similar-aged peers who are doing treatments, but I want to spend my time and money in other ways.
Monday
+1. I recommend The Unpublishable substack– she’s a beauty industry reporter who got sick of “exhausting and never-ending” beauty demands, especially with regard to aging.
nuqotw
+1. I don’t have the energy for these things.
ELS
Same. I am religious about sunscreen, moisturizing, and added retinol into my routine in the last 3 years or so. I’ve also recently gotten a microcurrent instrument for use at home, which seems to be providing some results. So basically, I’m willing to spend some time on this at home, but I’m not willing to significantly invest. I’m 27 with a narrow/oval face, so it’s just going to be what it is, IMO.
ELS
37. Not 27. It’s Monday!
Julie
I started at 50 and have Boxtox and fillers twice a year. I’m now 55. One of my favorite and cheap anti-aging products is the Gold Bond neck cream. That stuff is awesome. https://www.goldbond.com/en-us/products/neck-chest-firming
anon
+1 million. I am using my privilege to not participate in this stuff. There are always risks, in addition to the expense and time. I want it to remain normal for well off women to age in my area.
That said, I do engage in practices recommended for health that also slow the development of wrinkles, like wearing sunscreen/a hat, not smoking, etc.
Anonymous
I think this is a perfectly valid way of thinking about it. I started getting Dysport when I was 35. So I’ve done it for a little over two years. I’m pleased with the results so far. I’ve lost a lot of fat in my face recently, so I also discussed fillers and hyaluronic acid with the dermatologist who does my Dysport. I ultimately decided I don’t want to do fillers right now. I don’t think there’s anything wrong with doing them but it was going to be expensive (around $3000) and tbh the before and after photos the dermatologist showed me weren’t that dramatic. I decided for now to spend more money on makeup (not $3000 lol) and I’ve been happy with that decision. I will say women in my family tend to age kind of horribly so I think that’s part of why I decided to try it. There’s nothing wrong with aging but I don’t want to look haggard when I’m 50 either. I could see how it could become addictive but I don’t think i have the money or the friend group to get really invested.
anon
What does ageing horribly even mean?
Trish
Lol! Look, you are on a site that caters to fashion for professionals. Do you really believe that some of us don’t look better at age 60 than others just due to genetics and environmental factors?
Anon Gen X
While I have had minimal “work” done, I do want to caution those of you under 50 to “never say never.” Age discrimination is real – especially against women both in the workplace and in society in general. I would like to think that is going to change but I see absolutely no evidence of that. If anything, it is getting worse.
ELS
I think this is a fair assessment and a good reminder. My view now at almost 40 may be different as I age. At any rate, it’s a deeply personal decision, and I think all choices are valid.
anon
OP here, and that’s fair. I will fully admit that I’m still coloring my grays because I want to be perceived a certain way. And I’m getting tired of it, and am constantly debating just stopping. I just know that’s about as far as I’m willing to go at this point in time.
Anonymous
So true. I am 49 and have done basically nothing other than color my grays/whites, which I started early and will probably continue a bit too long. I haven’t ever thought I’d do a lot of or even any aesthetic enhancements and don’t expect I will ever do say, a full face lift. But at this point I am starting to see a little “tired” creep across my face and I can’t say I never will do Botox or the like, at least for my deep and deepening “11s”, or get a breast lift. I get some external and internal mileage out of looking and feeling younger. But I do want to be sure I don’t fall off the edge of trying too hard, esp. as I date younger men and could fall into the trap of seeming age inappropriate. I probably need to just start a skincare regimen for a year or two and go from there.
Anonymous
Yes but prolonging a youthful look is a difficult way of navigating this trend. If better off women look much younger, the rest will have an even harder time with age discrimination.
Anon
I’m not really up for solving the worlds problems on this one. I agree that age discrimination is very real and sorry, but a girl’s gotta eat and provide for her family. I’m getting the Botox and dying the hair and staying youthful as long as I can.
Anonymous
This is the crux of why I have a hard time with plastic surgery. Yea I might do it, but probably won’t be injecting botulism into my face while also prioritising organic unprocessed foods. 🤷♀️
Anon
Same.
eertmeert
Laser for my rosacea, baby botox for bunny lines and forehead. I did microneedling a few times several years ago, and it was more painful than laser, so I am uncertain if i will do that again. The boost to my confidence from having more even skin for the first time in my middle aged life is worth it. I leave the house without foundation regularly. I spend about the same amount per year on this as I do my 4x week pilates classes, so it all counts as self care to me.
Anne-on
+1 to laser for melasma/rosacea/acne – it’s been amazing to have ‘good skin’ for the first time in my 30’s after having to deal with PCOS related acne for decades.
I also do Botox about twice a year for my forehead lines and by my eyes – it’s small enough amounts to allow me natural movement but it also means I’ve made it to my early 40’s without any of the deep etched lines many of my friends (and my mom) had at my age. Did Juvederm once to deal with some sagging around my jowls and did not really like it so probably won’t try that again.
Thanksgiving anxiety
What lasers have you all had success with?
eertmeert
I think BBL? My derm offers BBL HERO and Clarity II, not sure which one I get. But I am pleased with it.
Anon
Thank you for these recommendations! I have a contraindication for Botox and wasn’t sure what rosacea would allow me to tolerate. But if laser actually helps maybe I should schedule with an aesthetician.
Trish
I really want my chest lasered. What do I even ask about? I have never been to a cosmetic dermatologist.
anon
Late twenties here. I’ve been wearing daily SPF (real sunscreen that you’d wear to the beach, not makeup or moisturizer that has SPF) since college. I usually stay in the shade when outdoors and always wear sunglasses during daylight hours. Part of this is vanity, part of it is my family history of skin cancer. I recently started using a prescription retinoid as well. I’ll probably begin using botox in my mid thirties. I plan to avoid fillers though –
it seems to distort your face over time.
At this age I already see a difference between my skin and my friends’. I was recently surprised to learn that many friends my age are already getting botox. Especially because these women rarely wear sunscreen and intentionally get tan in the summer. Botox can only do so much if you have sun damage.
ThirdJen
The giant air bubble in that syringe is giving me the heebie jeebies. On topic, I fall firmly on the “lots of water and sunscreen” side of the spectrum, along with keeping a bit more weight on than I might otherwise be happy with.
CreditRisk
I’m approaching 45 and focused on my hormone levels. Everything has gone haywire and it’s vital I’m on top of my health so I can remain working. Aging comes secondary to my hormones.
My skin is horrendous and my periods have all of a sudden dropped to every 15-20 days. Guess this is peri menopausal symptoms but I’m also totally stressed out.
My chin is horrendous and it’s clearly a double chin. I’m assuming it’s either allergies or a thyroid problem. Normal blood work showed everything to be normal so I’m paying extra to get a more in depth lab work done.
Anonymous
Same, girl.
Have you read about more fiber for balancing hormone levels? Gunter does talk about it in the Menopause Manifesto.
CreditRisk
Thank you for sharing that. I have a funny feeling I’m not eating enough vegetables and it’s caught up with me.
For years I’ve been in a very difficult marriage where he controlled the food in the house. My cooking was always ‘bad’ as too many vegetables and his meals were always great, but heavy, heart attack inducing meals with little to no vegetables. The stress from all of this also hasn’t helped.
Anonymous
I don’t really like the botox and filler look, so that’s not something I covet. I get why they do it, but am sad every time a new actress have lost normal mimicry and expression.
I love my crow’s feet, they’re staying.
If it were possible to buy great sleep, though…
Anon
I have done Botox for my 11s but never other lines. I just never worked up to it. I finally stopped Botox for both bugetary reasons and because at some point I have to age, right? But I miss it. I love that cool, calm feeling in my forehead. It’s something like smile therapy – it really did make me feel better not to frown or squint at my screen, and I really think it reduced the number of afternoon headaches I used to get. My mobility is back but the creases are still not as bad as they were when I first started getting Botox around age 40.
I have also had laser but that is more for broken capillaries/ rosacea damage. That is something I will probably get occasionally for the rest of my life.
I have a significant scar from an injury on one side of my fave. It comes across as a dimple or acne scar. The doc who did my Botox suggested zapping it with a deeper kind of laser and offered to do it for free, so I said yes, but it didn’t really work. My skin blistered up and peeled, as expected, but the scar is still there. He also suggested I could try filler but I just wanted to stop.
I have never thought of myself as any great beauty. I just want to look professional at work and not have a noticeable red nose these days.
anon
+1 to your last sentence. I’m pretty average, maybe slightly above on a good day, and I’m content looking pulled together and good enough.
Anonymous
After having to get shots in the sole of my foot for medical reasons, there is absolutely no way I want a needle anywhere near my face.
Anon
If you’re talking about steroid shots, I’ve had those. I’ve also had the kind that go in from the top to reach the sole, which grosses me out just thinking about it.
I’ve also had botox. Botox doesn’t hurt nearly as much. Just so you have a comparison, and I am in no way trying to talk you into botox!
Anon
I have a ‘to each their own’ attitude about all of this. My mom has had a lot of plastic surgery (tummy tuck, leg and arm lifts, face lift, blepharoplasty, lipo) and she looks great, like her best self, not at all fake. Beyond the visual benefits I also see that she is more active and more likely to do things like go to the beach, which has intangible value. And I think, it’s great, especially after three kids, to feel comfortable in your body at any age.
Personally I am not into the idea of surgery (I even had my wisdom teeth out one by one with only local numbing) but understand I might feel differently at 60 when my eyelids under the brow-bone are hanging down. That’s probably an exception I’d make because it seems relatively low-invasive and the difference is really amazing.
Botox isn’t for me because every time I seriously consider it, I think where I could be traveling with that money, and always choose the trip.
Anon
My husband will probably need that droopy eyelid surgery within the next 10 years for vision reasons. His mom had the same around the age he’s approaching now. It was far from cosmetic and she had visible scars, but at least she could see again!
anonshmanon
I feel like everyone should do whatever (and personally I am currently having a bit of a moment of not liking how I look, and reconsidering my stance of I-can’t-be-bothered-with-most-of-these). But calling it ‘Aging Intentionally’ is the height of double speak, when it’s really the intention of not visibly aging. Not a fan of that term.
Anonymous
Totally agree on the language. It is being used to mean the exact opposite of how I read the term.
Anon
Agree on the doublespeak.
Anonymous
Products and surgery to slow the appearance of the aging process is anything but “aging intentionally” when the expectation is to continue looking young.
That’s the sad difference between men and women. Men are never going to be concerned with this concept of “aging intentionally” because they are allowed to age.
AIMS
So I was at an event the other day where a woman came up to me to start a conversation precisely because all the middle aged men in her group were non-stop talking about what they were doing to keep their hair and she said it was dreadfully dull. I don’t know that this is progress but I do know a lot of men who are now falling prey to all the same beauty mania.
Anon
+1 I also know a decent number of men who’ve had Botox.
A
No work down but religious about sunscreen. I use retinol and glycolic acid. But genetics matter. I have great skin as of now. I’m 48, but I look like I’m in my late 30s. Confident enough to go grey during the pandemic. But I recognise I’m lucky. I don’t know how long it will last.
DC Attorney
I’m 35 and started getting “work done” about two years ago. I found my doctor via word of mouth and she’s incredible. I get a botox equivalent (tbh not sure what I use) in my forehead every 3 months and microneedling every 3 months (so I’m going to the doctor every 3 months but only getting each procedure done every 6 months if that makes sense). I get cheek filler once/year and lip filler every 3 months. It looks incredibly natural, no one notices except me which is just the way I want it.