How Botox is becoming a part of millennials' basic beauty regimen

Twenty-eight-year old Katy Young tries to stay ahead in this game of life.

She does CrossFit five days a week — a well-rounded workout now gives a foundation for good muscle tone later.

She just purchased a townhouse in Pittman, N.J. — a responsible way to build future financial equity.

And Thursday, Young got her second round of annual Botox injections — a head start on fighting later aging (and ensuring that her current selfies are picture perfect).

"You know that Instagram filter that everyone uses?" asked Young, an athletic trainer at Children's Hospital of Philadelphia with the words Fearfully Wonderfully Me tattooed in flamboyant cursive on her forearm. Cherry Hill plastic surgeon Steven Davis just finished injecting Botox in Young's forehead and around her eyes to smooth out barely there frown lines. "That's what you look like. You have an Instagram-filtered perfect face."

Young is one of the growing number of millennials who health-care professionals say are keeping standing appointments for nonsurgical beauty procedures like Botox and hyaluronic acid fillers Restylane and Juvéderm to attack faint laugh lines or plump up lips.

"These 20- and early-30-somethings are looking at these procedures as a form of self-care," said Debra Johnson, president of the American Society of Plastic Surgeons. "It's part of their skin care and general maintenance routines."

Still, Botox injections before your 30th birthday? It's hard for me to rein in the judgment. Maybe it's because the 20s should be a carefree time when you can eat French fries and bask in the glory of the blazing sun — and not worry you will instantly gain 10 pounds or 10 wrinkles. Most people would look back at their natural, twenty-something faces and kill for them.

On the flip side, back in the day, my friends weren't constantly checking in on our Snapchat stories or messaging Facebook hotties from our preschool past. With so much image-sharing, it's hard not to want to be perfect all day, every day, in every way.

"I work in a salon where everyone is so pretty," said Ana Sheridan, 28, a stylist at Salon Christopher Angelastro in Washington Township, N.J., who has been getting Botox every six months for two years. "I have a big forehead, and I'm very expressive, and I just wanted to fix the wrinkles. I also have uneven eyes. One is slightly lower. Botox tied everything together."

Johnson estimates that the number of patients in the United States who regularly undergo noninvasive surgeries has doubled since 2012. However, she added, the younger folks still make up less than 5 percent of the total number of patients.

For this particular segment of the in-office-procedure population, the face is the No. 1 focus. But perhaps youth is also the most body-conscious. So there is a lot of experimentation with procedures that melt (SculpSure) or freeze (Cool Sculpt) away fat from the midsection, thighs, and of course, the butt.

Major advances in the beauty industry have made such procedures more acceptable to the younger generation, said Margo Weishar, dermatologist and founder of Derm Aesthetics, formally Springhouse Dermatology. In other words, the stigma, unless you go Lil' Kim-too-far, is gone — yet another by-product of growing up in a generation with instant gratification at its fingertips.

Weishar, like many of the professionals interviewed, said she has had girls as young as 18 ask for Botox and filler information, but she gives them advice on how to better care for their skin (use sunscreen and stay moisturized) rather start them on fillers and Botox so early.

"People want the work, and they will even talk freely about having it. They just don't want to look overdone," Weishar said.

Davis refers to the busy, under-30 Botox-and-filler business at Davis Cosmetic Plastic Surgery as boutique Botox applications, because only a fraction of the product typically used is required.

For example, someone in their 50s may need roughly 25 to 50 units or $400 to $700 worth Botox to sufficiently knock out the forehead wrinkles. But a younger patient looking for the same results may only need 15 to 25 units, or $200 to $400 worth of Botox.

"That's because we aren't going after established creases or deep wrinkles yet," said Davis. "We are just trying to control the muscle activity so the creases and wrinkles don't get as extensive as they could."

In other words, get more Botox now so you need less later.

Registered nurse Candice Reid said the bulk of her young clients at Chestnut Hill's Forever Young Skin Care get hooked on the makeup-free look Botox provides. And those who get Botox and then apply makeup come to the conclusion that less is definitely more.

Skin is smoother so foundation is more shimmery for a highlighted effect. Eyes are lifted so eyeliner and mascara become accentuated. Filled-in lips are more pronounced so less lipstick is needed for definition and pout.

"For me, it was a beauty thing," said Norah Shah, 27, of Philadelphia. Botox "really opened up my eye area so my mascara popped. It made my forehead so smooth. I'm almost addicted to it."

But does anybody really notice?

"No, not really," Shah said. She paused. "Not even my boyfriend. He thinks he loves women who have a natural look. He just doesn't know what it takes to get it."