All that time staring at ourselves on Zoom has led to a rise in procedures like “baby botox.” The Atlantic’s Yasmin Tayag explains the lure and Dr. Michelle Hure injects some caution. This episode was produced by Amanda Lewellyn, edited by Amina Al-Sadi, fact-checked by Laura Bullard, engineered by Andrea Kristinsdottir and Patrick Boyd, and hosted by Noel King. Listen to Today, Explained ad-free by becoming a Vox Member: vox.com/members. Transcript at vox.com/today-explained-podcast. Image credit Visoot Uthairam/Getty. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Chapter 1: What sparked the trend of 'baby Botox'?
Okay, so the other day I was in Portland, Oregon on vacation. I'm hanging out, feeling really good about myself. And I walk past this store where a guy is offering free skincare samples. I say, sure, I'll take one. Then he literally grabs me by the hand and pulls me into his store. And suddenly he's putting like this goop under my eyes. And I'm not a big skincare girly, but I dabble.
And I'm telling you that this stuff was magic. Like, I have the beginnings of crow's feet, but I'm looking in the mirror and they're gone. And he tells me, this stuff costs $1,300, but it is so worth it because you won't need Botox for another three years. How old are you, Amanda? I'm 28 years old. Coming up on Today Explained... The pressure to fix your face.
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It's Today Explained. I'm Noelle King. Yasmin Tayag is a staff writer at The Atlantic, where she also hosts a podcast called How to Age Up. This is a show about rethinking aging, which Yasmin recently found herself doing when she noticed that many of her friends have been looking suspiciously good. Yeah.
Well, as a woman in her late 30s who is on Instagram all the time, I couldn't help but notice that some of my friends who are the same age as me look amazing. And I was like, wait, I know you're in your late 30s. Your face should not look that tight. What's going on here? So in person, I started to ask casually, like, what's your secret?
And everyone I spoke to was very happy to tell me that they've been doing baby Botox since their mid-20s.
What is baby Botox?
You can interpret baby Botox in two ways. The main way is that you use baby doses of Botox. So typically, a normal Botox procedure might use 20 to 40 units of Botox. A baby Botox procedure uses only 10 to 20. But I think it can also be interpreted to mean that it keeps you looking kind of like a baby from the moment you start. So baby Botox is thought of as a preventative procedure.
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Chapter 2: How does baby Botox differ from regular Botox?
This is super interesting. I'm a couple years older than you. I'm in my absurdly early 40s, let's call it. And my impression of Botox, which I haven't tried but definitely would, is that it is something we do in the shadows. It is not something that we tell our friend who is a literal reporter for The Atlantic about.
Yeah, you would think, right? And I'll tell you that I used to work in a Botox clinic when I was in college. Well, I was a medical assistant to a doctor who began moonlighting as an injectables doctor. And so I was exposed to a lot of the people who were coming in to get Botox. And this was in the... mid to late 2000s. And at the time, it was very secretive.
You know, people didn't want others to know that they were getting Botox. We would have women come in paying in cash because they didn't want their husbands or family members to know that they were paying for Botox. And I think a lot has changed since then. So when I was doing reporting for the story, something that came up a lot was the impact of reality TV.
I have Botox up here, here. I've had filler in my cheekbones, filler in the chin, filler in the jaw, and my lips, so pretty much my whole face except my nose.
Multiple women I spoke to mentioned Vanderpump Rules and The Real Housewives series. So I don't really watch these shows, but what my friends told me was that on these shows, the women are very open about their Botox use. I get Botox and I get filler. I've always done that.
Okay.
And I take care of my skin. Lots of water.
Okay.
And I lost some weight. And I think that openness just sort of bled out into the wider culture, leading us to a place where people aren't really embarrassed anymore.
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Chapter 3: What cultural shifts have influenced Botox popularity?
There are some other things, of course, driving this baby Botox trend. I mean, the fact that so many people are on their phones all the time, taking photos of themselves, streaming on TikTok. You know, you're looking at your face constantly.
Hey guys, get ready with me.
I'm 39 years old, I'm obsessed with skincare, and this is my nighttime routine for glass skin, including a new product.
If you think you have a double chin, you actually probably don't. Probably just excess lymph fluid that's sitting in this part of your face.
And the same goes for having been on Zoom for all of the pandemic.
Where are we looking during our Zoom calls? Are you looking at yourself to make sure you're not doing anything weird? Cause that's what I tend to do.
I actually purposely move my viewfinder close to your face. So you think I'm looking at you, but I'm really not. I'm really not.
When you're looking at your face all the time, you're spending more time with the wrinkles and the fine lines that are forming. I think broadly our culture has just become so visual. We're always looking at faces on social media. We're seeing our faces juxtaposed with those of celebrities who look incredible, possibly because they are doing so much baby Botox and other procedures.
Can I tell you my theory based off of what you just said?
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Chapter 4: How expensive is baby Botox and why do people budget for it?
You know, in New York City, at least, a mani-pedi can go for $100 easily.
Yeah, I paid $87 the other day without tip.
It's too much, yes, with the tip. It's crazy. And so I think when you view it as just a part of your normal skincare routine, you know, $200 isn't that big a leap, especially if you consider it as potentially reducing your reliance on other types of cosmetics or anti-aging procedures.
Is there any danger to starting Botox when you're in your 20s?
I think something that should really give people pause is that we don't really know that much about the long-term effects of Botox, of regular Botox use. So the baby Botox trend began somewhere in the aughts. And we just don't really know what happens because there just hasn't been enough time to see what the long-term effects can be.
But some of the dermatologists I spoke to for this article told me that broadly, one issue with Botox is that if you paralyze the muscles in one part of your face... The other muscle, like it still wants to move. Your face still wants to move. And so other muscles can try to compensate. And so, you know, you'll start seeing wrinkles in those areas and potentially need to get Botox there.
So I think one potential consequence of regular Botox use from a very young age is that you become dependent on it.
Yeah, you're like chasing the aging all around your face. That's actually super interesting to think about. If your forehead doesn't wrinkle, something else somewhere on that face is going to move. And then, you know, a couple of years from now, you might be chasing that with the injectable. Let me ask you, you host a podcast about aging. You try to be optimistic.
You also know, I would imagine, that there's a lot of pressure to look positive. younger than you actually are. If baby Botoxing becomes a bigger trend, could it become kind of an arms race where you've got a whole generation of 50-year-olds who look 30 and then everyone has to change and double down in order to look good for their age?
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Chapter 5: What are the potential dangers of starting Botox in your 20s?
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So my name is Michelle Heery. I'm a physician. I do dermatology and dermatopathology, which is looking under the microscope for skin biopsies and whatnot. And so I'm seeing patients, medical patients, cosmetic patients, and occasionally surgery. And I have my own office. So I started my practice at the end of 2015 and really got into the swing of things in 2016.
And I really didn't start seeing that uptick of younger cosmetic patients until the pandemic. Everyone was basically chronically online. They were on Zoom. They were looking at themselves. And there was the rise of TikTok and the filters. And people were really, you know, seeing these flaws, these perceived flaws that either aren't there or are so minimal and just normal anatomy.
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Chapter 6: What are the long-term effects of regular Botox use?
I don't see a lot of signs of aging on her face, but she was coming in for neurotoxin, Botox, Dysport, that sort of thing. You know, I really had to kind of search for movement on her face already. So there wasn't a lot for me to treat. So I told her, you know, okay, no problem. I will do a little bit. I mean, I see maybe it helps with your 11 lines in the middle.
You know, maybe if you're looking angry, that's fine. No problem. We'll do a little bit. And at the end of the session, you know, she was asking me, so what do you think about my nasolabial folds? Basically, it's the fold that goes from the corner of your nose, your nostril, to the corner of your mouth. And it is kind of the barrier between the nostrils. kind of upper lip and your cheek.
And when you smile, it kind of folds like that. Of course, the more you age, the more of a line will be left behind when you're not smiling. And she was just, you know, she's pointing to her cheek as if there was something there, but there was nothing there. And so I had to tell her, like, well, I don't see that. You're perfect. It's a phantom nasolabial fold. It didn't exist.
So I had to bring a mirror out and show her. There's nothing here, right? And so... That sort of mentality where someone really is perceiving a flaw that is absolutely not there, providers need to say no.
Unfortunately, they're incentivized not to, especially if you have a cosmetic office, if you're a med spa, if you're a cosmetic derm or plastic surgery office, of course you're incentivized to do what the patient wants. Well, I'm not going to do that. That's not what I do.
So you said no to this young woman and sent her on her way. Yes. Which means you may get paid for seeing her in that visit, but you're not getting paid for putting filler in her face. Of course. I think what I hear you saying is other doctors would have done that.
Absolutely. 100%. And I know this for a fact because many times those patients will come to my office to get that filler dissolved because they don't like it. In the larger practices or practices that are private equity owned, which is a huge problem in medicine, you are... Absolutely meant to sell as many products, as many procedures as possible.
Oftentimes, I was told to sell as much filler as possible, right? Because every syringe is several hundred dollars.
Huh.
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