More millennials are getting “preventative Botox” to beat wrinkles before they appear, says this report from The Face. In the last five years, Botox procedures among 19-to-34 year olds has risen by 87%. “Rather than trying to ​‘cure’ my wrinkles when I’m 50, I tried to prevent them in my 20s and 30,” said Emma Copeland, who’s been getting injections since she was 25.

For these people, Botox is a regular part of their beauty routine – and since effects last for about 4 to 6 months, that means getting injections 2 to 3 times a year. But that makes us wonder: what does taking regular Botox injections really do? Is it safe? What are the long-term effects of getting Botox?

 How does Botox work?

“Botox prevents the communication between your nerves and your muscle,” explains dermatologist Mara Weinstein. A lot of the wrinkles that later appear on the forehead and around the mouth are caused by decades of frowning, smiling, squinting, and raising eyebrows. The repetitive movements etch lines on our face, like water wearing down a path on a stone.

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Botox can “train” your facial muscles

All muscles grow weaker if you don’t use them, and that also applies to the facial muscles that can cause frown lines. “If Botox is used regularly, over a prolonged period of time, without interruption, eventually the muscle will atrophy from lack of use,” says famous dermatological surgeon Patricia Wexler.

Furthermore, if you completely stop Botox, after a few months your muscles will regain strength. Just like it can unlearn movement, it can relearn movement.

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You will still have facial expressions

As long as you go to an experienced aesthetic doctor who knows exactly where to inject the Botox, your other facial muscles will still work to give you a wide range of expressions.  

 Your skin may become thinner

Dr. Wexler says that some patients who use Botox for several years developed noticeable thinning of the skin around the treatment areas. “The skin of the forehead

get prematurely thinner, and muscles weaker.” While this is not common, it is something to consider if you want to start Botox in your 20s or early 30s. It rarely occurs in patients who begin Botox at a later age.

Is that risk enough to delay Botox until you’re older? Not necessarily. Since you know that thinner skin is a risk, you can your dermatologist about the best skincare regimen to counteract it. Products that encourage cell generation, protect your moisture barrier, and encourage collagen and elastin can keep your skin in top shape, now and in the future.

You may get “wavy” skin

This is a rare side effect of having Botox injected in the same areas for several years. “On expression, the forehead may even appear like hills and valleys,” explains Dr. Wexler. This can be avoided by adjusting the injection patterns: smaller amounts given more frequently, or injected in other areas to produce similar effects. Talk about this with your cosmetic surgeon.

You’ll need less sessions

Regular injections will weaken the targeted muscles, which means there’s a chance that you’ll need less injections to maintain the results.

However, that assumes that you’re also practicing the right skincare routine and lifestyle to prevent wrinkles. “Botox can paralyze the muscles that cause dynamic wrinkles, but it can’t prevent the fine lines that are caused by sun damage, smoking, unhealthy diet and lifestyle, and irregular skincare,” says dermatologist Hannah Grover.  

You’ll still enjoy some benefits after you stop

Let’s say you do Botox for a year; will the wrinkles suddenly appear when you stop? No. If you decide to discontinue treatments, you’ll still benefit from taking a treatment that helped delay ageing. It may take longer for wrinkles to form or appear, especially if the muscles were left very weak. In a way, you borrowed time for yourself – and the quality of your skin then depends on how you take care of your skin after Botox.