Botox/filler Should I Do It Now or Wait Til I'm Older and Really Need It?

36 yrs old and no Botox or anything yet but have noticed some slight crepiness under my eyes when I smile. It's not terrible but it bothers me sometimes. I don't want to change my looks and would hate to make the problem worse by messing with nature. Lol. Should I see how much longer I can hold off or attend to the problem now? I'm one of those " less is more" believers and would like very subtle improvement. Should I just try creams or laser? Which has less side effects: Botox or filler?

Doctor Answers 16

When is the best time to have Botox?

There is really no predetermined age as to when one should have Botox treatment. If there is an area that bothers you, it does not hurt to try. Botox and filler are generally used for different purposes, and potential side effects are minimized when the injections are performed by an experienced physician. Botox is derived from Botulinum toxin type A, and will paralyze the muscles in a given area, causing wrinkles to smooth. Fillers are made of hyaluronic acid, and will actually fill in the wrinkles. From here, I would recommend a consult with an experienced physician, as he/she will be able to assess your needs and provide you with advice. Thank you and I hope this helps!

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Botox/filler Should I Do It Now or Wait Til I'm Older and Really Need It?

There is no set "best age" to start using Botox. Younger patients, like yourself, often approach Botox as a preventative maintenance tool -- preventing the wrinkles before they occur, and this is perfectly acceptable. A great skin care regimen is equally as important, especially in younger patients. Botox won't "change" your looks -- it will make you appear more rested if properly injected.  Choosing a "core" Botox injector will be the most important step (facial plastic surgeons, plastic surgeons, dermatologists, or occuloplastic surgeons). This is because we all have a keen understanding of facial anatomy and the effects of injecting Botox/ Xeomin/ Dysport and fillers in different regions of the face. An in-person exam is absolutely necessary in your case to check your dynamic facial expressions and discuss your concerns/ expectations prior to developing a treatment plan. Be sure you are seeing one of us, and I wish you well!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 47 reviews

Botox (and Dysport and Xeomin), Superficial Peels And At-home Prescription Meds Work Well For Crinkles Under the Eyes At Any Age

When many options are available for treating a certain problem, my rule is that I recommend for my patients what I would do for myself and my family if they had the same or similar problems. I have already treated several of my sons, beginning from their late teens and later their wives in their twenties and early thirties with Botox (and Dysport and Xeomin) as well as fillers, both hyaluronic acid and calcium-based, for a variety of wrinkles, furrows and crinkles.

It is generally believed these days that the earlier one starts these kinds of treatments, even preventitively, the less back-peddling will be necessary later on, and the far more likely that the need for aggressive surgeries, such as facelifts, necklifts, and eyelifts, may be mitigated. This may be an instance where the "less is more" philosophy followed early on may possibly result in requiring a whole lot more intervention later on. Early intervention with nonsurgical rejuvenation treatments, like Botox, fillers ,volumizers, peels, and certain prescription topicals may actually constitute "a little bit now and a much less needed later on" scenario.

Overall, I have not been impressed with lasers, including fraxels and other energy-based devices for many of the uses they are commonly touted for. They seem to be subject to too much of the "next best thing" type of marketing hype. Chemical peels, particularly a series of superficial peels under the eyes, are tried and true and may be helpful in this type of case, either alone or in combination with home prescription creams containing retinoic acid and/or alpha hydroxyacids.  

Botox (as well as other neuromodulators, such as Dysport and Xeomin) work well for the fine horizontal crinkles under the eyes that result from hypertrophy of the muscle in that location and so in this case may be worth a try. Occasionally fillers, particularly Belotero Balance, can be used to soften fine crinkles, as well. This is not an area for beginner injectors. Consultation with a board certified aesthetic physician with long experience in treating this location is strongly advised.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

Botox, filler and laser to treat and prevent lines

You should consult an experienced dermatologist or plastic surgeon to assess your crepiness and determine which treatments would be best for you.  Botox, filler and laser may all be appropriate treatments for you.  These treatments complement each other to give a very natural look and are also preventative.  You should also use sun protection.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Botox/filler use in lower eyelid region

Do not use botox in the lower eyelid region as it can cause a drooping eyelid called ectropion.  Botox is better used in the crow's feet area of the eyelid.  The best solution for minor crepiness in the lower eyelid region would be laser skin resufacing or chemical peel. Fillers are used to treat lines or grooves at rest, while botox treats dynamic lines formed when you animate.  They both can be used in your 20's, 30's, and 40's toprevent deeper line formation as you age.

Peter J. Simon, MD
Fort Lauderdale Plastic Surgeon
4.7 out of 5 stars 3 reviews

Botox and Filler to Address Wrinkles

Botox would help address the fine lines around your eyes commonly referred to as “crow’s feet.”  There are generally two types of wrinkles: static wrinkles and dynamic wrinkles.  Fine lines caused by repeated muscular movement are a type of dynamic wrinkle.  Botox, a muscular relaxer, prevents the movement of the muscle underneath skin thus helping prevent wrinkle formation of the overlying skin.  If your main concerns are lines forming beneath your eyes then Botox has limited use in this area of the face.  Skin treatments such as superficial peels and laser treatments work best in this area.

Anthony Bared, MD, FACS
Miami Facial Plastic Surgeon
4.9 out of 5 stars 70 reviews

Botox and Filler as Wrinkle Prevention and Treatment

Thank you for your question.

Botox and Dysport are commonly used for dynamic wrinkles (lines created by muscle movement) and fillers like Juvederm and Restylane are used for static wrinkles (wrinkles like nasolabial folds and marionette lines).  Botox and Dysport are more commonly used to in a preventative fashion.

Specifically the progression of fine lines around the eyes (Crow’s Feet) can be effectively slowed using Botox or Dysport by relaxing the underlying muscles that contribute to the severity of the wrinkles. Generally speaking Botox and Dysport for the Crow’s Feet has a subtle effect and does not change the appearance of the eyes, however, sometimes the lines under the eye may be more noticeable in contrast to the smoothness of the sides of eyes that have been treated with Botox or Dysport. In either case topical tretinoin may be included to further reduce the fine lines. Other options may include laser resurfacing or surgery but have much greater downtimes and are generally reserved for more severe wrinkles or folds.

For a formal evaluation and consultation visit the office of a board certified plastic surgeon.

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 49 reviews

Botox in Younger Patients

Many younger patients get botox to prevent wrinkles from forming later. Botox can not only improve wrinkle which occur when you move your face now, but also if done consistently can prevent future wrinkles from forming in the first place.

Michael Horn, MD
Chicago Plastic Surgeon
4.4 out of 5 stars 54 reviews


It is quite common for me to see patients your age in my office. Botox is one of the best things around for eliminating fine lines and wrinkles such as the ones you have. Rather than "plumping" like collagen and fat, Botox blocks the impulses that nerves send to muscles, essentially paralyzing the muscles and diminishing their ability to tense. Using a very fine needle, the surgeon injects Botox in small doses where the facial muscles are most active--between the eyebrow and at the sides of the eyes, or beside the mouth. After receiving treatment, you're forbidden to lie down for several hours, because the medicine can absorb unevenly. It takes one to three days to see the effects, and the treated area will continue to improve for up to two weeks. That's when I schedule my patients to return, to see if a touch-up is needed.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Preventative fillers and Botox

I operate under the less-is-more philosophy like many others and absolutely do not try to change what people look like, but rather enhance it. I have people as young as 20 doing fillers and Botox in my office, and they do it for preventative measures, so they don't get the lines, wrinkles, etc. that their mothers and grandmothers and aunts etc. battle with. There is a lot to be said for preventative treatments, but in moderation. Visit a board-certified injector (or a few) for an opinion and consultation. The other thing - wear daily sunscreen - that helps tremendously!

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.