One identical twin, 38, had Botox for 20 years

• One twin underwent Botox consistently while the other only got it a few times
• They were pictured at age 38 (first images) and at 44 (images lower) 
• READ MORE:  I’m a plastic surgeon – this is how you make your Botox last longer

Ever wish you could see what you’d look like with Botox? 

A unique study of identical twins gives one of the clearest examples of how the shots change someone’s facial appearance.

The women were followed for nearly 20 years, with one receiving Botox injections two to three times a year and the other letting nature take its course.

The case report, written by a Beverly Hills plastic surgeon, compared several images of each twin at different time intervals.

They were first pictured in 2006 at age 38 and taken as they ‘rested’ their faces. 

At that time, one of the twins had undergone at least 26 Botox injections over the course of the 13 prior years and the other had received only a couple of shots.

The twin who’d received the treatments regularly had noticeably smoother skin with more shallow wrinkles on her face.

Her sister, meanwhile, had deeper forehead lines and more noticeable crow’s feet when she smiled compared to the twin who had undergone the shots.

They were then followed up at age 44 in 2012 – at which point the Botox twin had been getting the injections for 19 years.

By this point the no-Botox twin had a noticeably puffier visage and a wider jaw – though it is not clear whether the Botox was a factor.

For the 2012 follow-up, both twins said they had used sunscreen consistently, ruling out the possibility that wrinkles could have been caused by long-term exposure to the sun’s UV rays. 

Neither used retinol for wrinkles and led mostly healthy lives.

Why are Gen Z aging so differently compared to millenials? 

Healthier diets, better knowledge of skincare and improvement in make-up means those born 1980 – 1997 appear much more youthful than those in decades past did at the same age. 

And the twins lived on different sides of the world with significantly different levels of sunlight. 

The twin with sporadic treatments and more lines resided in Munich, where the average UV index is lower compared to Los Angeles, the location of the other twin.

Dr William Binder, who reported the case study, claimed it ‘is likely that long-term treatment with Botox is able to prevent the development of imprinted lines not only by inhibiting the patient’s ability to contract the target muscle but also perhaps through behavioral modification.

‘With long-term treatment, the patient may become used to having little, if any, need or ability to contract the target muscle and may eventually “learn” to avoid even trying to contract it.

‘It is also thought that, by relieving the mechanical pressure of chronic muscle contraction in this way, dermal remodeling may be facilitated.’

Wrinkles form when facial muscles contract. At the same time, the production of collagen and elastin, proteins that provide structure and elasticity to the skin, decreases with age. 

The skin becomes thinner, drier, and less able to retain its shape, leading to the formation of wrinkles.

Botox injections are extremely popular. Over 8.7 million cosmetic procedures were carried out with them in the US in 2022. But the injections are not without risk. 

The shots can cause bruising, swelling, and redness where the needle was injected. And the face can take on a frozen look, while also showing droopiness by the eybrows or eyelids. 

More serious reactions including anaphylaxis, shortness of breath, headache, and even flu-like symptoms.