"Women begin losing volume in their 30's, with fat and bone loss progressing with each decade. In an individual with very low body fat, Sculptra can be used in small amounts early to maintain the convexities of a thin face, or to improve the attractiveness of a face that has poor convexity in an area congenitally.  Botox is often begun in a patient's 30's for dynamic wrinkles in lighter doses.  I have used it in patients in their 20's if they have deep frown lines that run in their family." says Dr. Olson.

In a recent JAMA Dermatology Viewpoints article published online first, Heather K. Hamilton, MD, and Kenneth A. Arndt, MD, both of SkinCare Physicians, Chestnut Hill, Mass., make the case that it’s rarely “too early” to treat patients with “appearance-enhancing procedures,” such as neuromodulators, fillers, and light or laser treatments. 

“If the action of the muscles of facial expression is diminished, the lines on the face that are interpreted as aging, tiredness or anger will simply not form. Initiating regular treatment with a neuromodulator in an individual’s 20s or 30s will have a dramatic effect on the appearance of the face as seen in the person’s 40s or 50s. There will be few, if any, lines of facial expression present.”

The authors conclude: “Similar to our advocacy for the early use of other strategies to avoid or diminish the evolution of age-related changes such as sunscreens and topical retinoids, the initiation of conservative and thoughtful use of neuromodulators, fillers, and noninvasive energy-based treatments, alone or in combination, will keep patients looking young and their skin looking healthier. So there really is rarely a time that is too early. Perhaps the better question is, ‘When is it too late?’”

(JAMA Dermatol. Published September 18, 2013. doi:10.1001/jamadermatol.2013.5399.)

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