Do age, gender, or ethnicity matter when considering Botox?

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The short answer is yes.

The more detailed answer is: it’s a little complicated 🙂 Read on or click the ‘play’ button on my podcast below to hear my more detailed response.

Age Influence on Botox

When we consider age, let me start off by stating that we use the same amount of units, whether you’re young or old.

In general, a rough rule is that we need the same amount of medicine (Botox) to get the muscles to stop moving.

There is one caveat. Sometimes when we use Botox on a younger patient, the procedure tends to do something called atrophy to the muscles that we’re paralyzing.

What that means is that if we repeatedly paralyze those muscles, those muscles tend to get smaller. In essence they become less strong.

As patient’s age, and continue using Botox, we need to use less and less Botox as the years pass.

Is it a dramatic reduction?

Only time will tell. That is unique for each patient. It definitely is less, just because we’re making those muscles smaller.

Gender’s Influence on Botox

The second question is does gender matter?

My answer is a resounding YES. The reason for that is that we’re injecting around the eyes. Between the eyebrows, the forehead, and around the crow’s feet. Women and men have different-shaped eyebrows. We want to preserve that. We don’t want to feminize men, and we don’t want to masculinize women.

When it comes to women, we really want to preserve a natural arch of the brow. I am conservative in injecting directly over the eyebrow. The more we inject closer to the eyebrow, the higher the risk is that we can drop the eyebrow down. If we drop the eyebrow down, it becomes more level and not so arched. When it becomes more level, it looks more like a man’s eyebrow.

For male patients we don’t want to inject high up on the eyebrow. This would leave a big gap between injection site and the eyebrow itself. In that case, we’re feminizing the eyebrow. For men, we also don’t inject too much around the crow’s feet, because that will raise the eyebrow and also give an arched look.

Ethnicity Influence on Botox

When it comes to ethnicity, it’s a little bit more complicated.

People will tend to have differently-shaped eyes and eyebrows.

Some people have thicker eyebrows. They might want to preserve the way their eyebrows look or maybe make them change. We’ll have to play that by ear per patient.

I don’t have a single hard and fast rule about what to do per patient population.

I hope that helps. If you have any other questions, you can shoot us an email at