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

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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.”

Also known as preventive Botox or “micro-tox,” baby Botox is a growing trend among younger adults, especially first-time users and professionals seeking a refreshed yet understated look. Much like traditional Botox, the treatment may help smooth and soften fine lines and wrinkles. However, it uses smaller, precisely targeted doses to achieve subtler results.

Of course, just like regular Botox (or any medical procedure), preventive Botox carries some risks, and seeing a licensed medical provider is crucial.

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.

Botox is a brand of botulinum toxin type A approved by the U.S. Food and Drug Administration (FDA). Other brands include Daxxify, Dysport, Jeuveau, Letybo, and Xeomin.

These injectable neurotoxins temporarily block nerve signals to muscles to prevent them from contracting.

While Botox can also help treat health conditions such as migraine and excessive sweating, it's been used by providers for cosmetic purposes for more than two decades.

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.

But Botox and baby Botox are essentially the same, with a few key differences.

First, most people seeking Botox for cosmetic reasons already have moderate to severe fine lines or wrinkles, says Geeta Yadav, MD, a board-certified dermatologist and founder of Facet Dermatology in Toronto.

Preventive Botox, on the other hand, is best for those who are just noticing lines and wrinkles start to form, Dr. Yadav says.

“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.

The other difference between traditional and baby Botox is that the latter involves administering much lower doses to a specific muscle, rather than to a general area of your face.

Botox is measured in units, a specific measure of potency. While a regular Botox injection uses about 40 units for the forehead and frown lines, an average baby Botox treatment only uses about 10 units through hyper-localized micro-injections.

The following are some examples of typical preventive Botox injection sites and the average number of units used:

  • 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.

Usually, a preventive plan involves recurring treatments every three to four months, just like with traditional Botox, says Robyn Gmyrek, MD, a board-certified dermatologist at UnionDerm in New York City.

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.

So, does preventive Botox work? When used appropriately, yes, Yadav says.

Repetitive facial-muscle movements cause creasing and folding of the overlying skin that, over time — along with aging, sun exposure, and other factors — damage that skin to the point that wrinkles appear when the face is at rest, Yadav says.

“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.

In a recent review, researchers analyzed nine studies on preventive Botox, which included 1,203 total participants. They concluded that it may help delay the appearance of wrinkles and preserve skin elasticity. However, they noted that more high-quality, long-term studies with standardized designs are needed.

In another review, researchers analyzed four studies in which most of the 2,528 total participants were women ages 28 to 30, most of whom sought Botox to prevent wrinkles from forming.

 Again, the study authors concluded that preventive Botox may be effective, but more research is needed.

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.

Botox is generally safe for most healthy people, with some exceptions.

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
Most side effects and complications are mild and temporary, according to one review.

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

“When you use Botox regularly over time, especially in high doses or too frequently, the treated muscles can weaken from lack of use, just like any muscle that doesn’t get exercised,” Dr. Bartholomew says.

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.

Fortunately, facial muscles can usually regain strength once the Botox wears off and you start using them again, Yadav says.

That said, Bartholomew notes that the changes can sometimes become permanent if the issue isn’t addressed.

 “It’s a subtle change, but over time it can alter the dynamics of your face, and in some cases even cause lines to appear in new areas,” he says.
Overuse — for example, getting injections more often than once every three to four months for several years — raises the risk of atrophy, Yadav 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.

Very rarely, neurotoxin treatment can lead to more-serious complications as well, including muscle paralysis and botulism.

 Complications are most likely to occur with improper injections or the use of products that haven’t been approved by the U.S. Food and Drug Administration (FDA), Yadav says.
Seeing a licensed injector — such as a dermatologist, plastic surgeon, or certified nurse injector — can improve your chances of a safe and positive experience, says Alison Todd, NP, who is board-certified and specializes in aesthetic care at Plastic Surgery New Albany, an Ohio State University Wexner Medical Center practice in New Albany, Ohio.

 

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

Not everyone is a candidate for Botox (preventive or otherwise), including those who’re pregnant or breastfeeding.

 

You may also need to avoid Botox if you have:

  • A neuromuscular disease such as myasthenia gravis

  • Weak facial muscles

  • Drooping eyelids (ptosis)

  • Infection or inflammation at the injection site

  • An immune-system disorder

  • A known allergy to the medication or its ingredients

Also, you may need to avoid Botox if you’re on certain medications, including muscle relaxants or antibiotics such as aminoglycosides, Bartholomew says.

 These may amplify Botox’s effect or cause the medication to spread beyond its intended area, he says. “In very rare cases, this could cause too much muscle relaxation.”

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

Only licensed medical professionals can legally provide Botox.

“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.

Cosmetic Botox is generally not covered by insurance, as it’s considered an elective procedure that’s not medically necessary.

 The cost of preventive Botox varies based on factors including a provider’s expertise and location, the brand of neurotoxin they use, and the number of units.

But the average, standard Botox treatment uses about 20 to 40 units, and costs between $325 and $600.

“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.”

A preventive Botox procedure is basically the same as if you were getting traditional Botox. It begins with a consultation with your licensed practitioner to discuss your goals and see if it’s right for you.

If you decide to schedule a treatment, your provider will likely ask you to avoid using blood-thinning medications, drugs like aspirin and ibuprofen (Advil, Motrin), and supplements like fish oil for several days beforehand to reduce your risk of bruising, Todd says.

Drinking alcohol can also promote bruising, so Todd recommends not having any for at least 24 hours before your procedure.

Also, Todd recommends not using retinol for at least two days before your treatment, because it accelerates cell turnover, which can thin the outer layer of skin and increase sensitivity.

 
When you arrive for your appointment, your provider will cleanse the treatment area with alcohol, Todd says.

 Then, they’ll insert a small needle into the target muscles, which may cause slight discomfort, she says. Altogether, most procedures last about 15 minutes, Todd says.

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.

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

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

  • 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.

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

Also, you’ll want to avoid other cosmetic procedures — such as laser treatment, microdermabrasion, and facials — in the week following treatment.

After four to seven days, the Botox should settle and start to take effect.

“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.

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