How Barely-There Botox Became the Norm


Kathryn Gongaware, a 32-year-old yoga teacher and comedian in Chicago, was always curious about Botox, but it wasn’t until she started mentioning it to friends and realized that people she wouldn’t have expected (including her au-natural-everything acupuncturist) were getting it that she felt comfortable making the jump at age 30.

“The more people were open about it, the more it felt destigmatized,” she said.

This forthrightness has been particularly transformative among women of color, who are often left out of conversations and marketing about cosmetic procedures. There’s also a deeply rooted stigma in many communities of color that by opting for cosmetic procedures that have inclined toward European beauty ideals, you’re rejecting your roots, said Dr. Onyeka Obioha, a dermatologist in Los Angeles who has been getting Botox since she was 25.

“Historically, and even today, the majority of advertisements for cosmetic procedures do not feature or target minorities,” Dr. Obioha said. “But now with social media, there’s more attention given to the fact that women of color also get cosmetic procedures, so the stigma surrounding them seems to be decreasing.”

While online sharing has helped reduce the stigma, it has brought with it some downside, too — namely, young people thinking they need to start Botox because their friends are doing it.

“I’ve had 20-year-olds in college come in without knowing anything about Botox who really don’t need it, but they have this sense of FOMO because their friends are doing it,” said Dr. Sheila Farhang, a dermatologist and cosmetic surgeon in Arizona, who doles out skin-care tips to thousands of followers on Instagram and YouTube. “I will not inject someone that age, and I try to explain to them why they really don’t need it.”

A shift in how Botox is administered has also helped convince younger people to try it. “When Botox first came out, people were using it to really isolate and freeze the muscles, so that frozen look was what people associated it with,” Dr. Schaffer said. At the time, doctors were using 20 to 30 units in one area or muscle alone, a dosing that has lowered significantly in the last 10 years.

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