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See the Difference Between One Twin Who Got Botox for 20 Years and One Twin Who Did Not

Side-by-side images of two identical female twins' faces against a blue background. The twin on the left shows visible signs of aging, such as fine lines around the eyes and mouth, while the twin on the right has a smoother complexion with fewer wrinkles, suggesting the effects of Botox treatments
Source: American Medical Association

In a study on the long-term effects of Botox, researchers focused on identical twins, one of whom regularly used Botox for nearly 20 years while the other did not. This study provides a unique insight into the impact of Botox on aging. Initially documented in 2006, the twins were 38 years old. 

At this time, one twin had received Botox injections regularly for 13 years, approximately two to three times a year, mainly in the forehead and around the eyes. The other twin had much less exposure to Botox, receiving it only twice during that period.

Photos taken for the study showed notable differences between the twins. The twin who consistently used Botox had noticeably smoother skin, with shallower facial wrinkles. In contrast, her sister exhibited deeper forehead lines and more pronounced crow’s feet, especially when smiling, per information from The Daily Mail.

This difference became even more apparent in a follow-up six years later. By then, the Botox-using twin had been receiving treatments for 19 years. The non-Botox twin, despite living in Munich with a lower UV index compared to her sister in Los Angeles, displayed a more aged appearance, with puffier features and a wider jawline.

Unliad reports that the twins’ different living environments played a significant role in the study. The one residing in Munich experienced less sun exposure than her sister in Los Angeles. Yet, despite the higher UV levels in Los Angeles, the twin living there showed fewer signs of aging, suggesting that Botox may have had a protective effect against the development of wrinkles. 

Dr. William Binder, the author of the study, stated, “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.”

The study’s findings are significant in understanding how Botox impacts the aging process. While both twins led similar lifestyles and consistently used sunscreen, their contrasting appearances provided insights into the efficacy of Botox treatments. The regularly treated twin exhibited virtually no forehead lines at rest, whereas the sporadically treated twin showed visible static forehead lines. The crow’s feet were also milder in the Botox-treated twin.

According to the Mayo Clinic, Botox, also known as Botulinum toxin, works by relaxing facial muscles, thus smoothing lines and wrinkles. It is not a permanent solution, typically lasting up to four months per treatment. 

In 2022, over 8.7 million cosmetic procedures involving Botox were performed in the US, per the Plastic Surgery Statistics Report, conducted by the American Society of Plastic Surgeons (ASPS). However, Botox is not without risks. The Mayo Clinic explains that side effects can include bruising, swelling, redness at the injection site, headaches, flu-like symptoms, and in some cases, more severe reactions like allergic reactions and breathing troubles.

This study of the identical twins offers a rare and comprehensive look at the long-term effects of Botox. 

The authors state, “Imprinted forehead and glabellar lines were not evident in the regularly treated twin but were evident in the minimally treated twin. Crow’s feet were less noticeable when the regularly treated twin smiled (even at 7 months after treatment) than when the minimally treated twin smiled.” This comparison provides valuable insights for those considering Botox treatments.


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