One identical twin, aged 38, had Botox for twenty years, the other did not. Who do you think looks better?

Have you ever wished you could see what you would look like with Botox?

A unique study of identical twins provides one of the clearest examples of how the recordings change a person’s facial expression.

The women were followed for almost twenty years from the age of 38, with one receiving Botox injections two to three times a year and the other letting nature take its course.

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

AFTER 13 YEARS: The twin who received very few injections – image A – next to the twin who received regular Botox – image D. The twin who did not receive the injections had more pronounced lines on her forehead and between her eyebrows

The images show that the twins who received very few injections – images B and C – and the one who received regular Botox – E and F – had significantly more forehead wrinkles

They were first photographed in 2006 and taken while ‘resting’ their faces.

Opinion poll

Who do you think looks better?

  • The twins with Botox 0 votes
  • The twins without Botox 1 votes

At that point, one of the twins had received at least 26 Botox injections over the previous thirteen years, while the other had received only a few injections.

The twin who had undergone 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 twins who had the injections.

They were then followed up in 2012 – at which point the Botox twins had been receiving the injections for 19 years.

At that point, without Botox, the twins had a noticeably thicker face and wider jaw, although it’s not clear whether the Botox was a factor.

Crow’s feet when smiling are more visible in the twin who let nature take its course – images A and B. The regularly treated twins – images C and D – had much less pronounced crow’s feet

Pictured are the areas where one twin received Botox injections in the forehead, glabellar (between the eyebrows) and crow’s feet

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

Neither of them used retinol for wrinkles and lived a mostly healthy life.

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

The twin with sporadic treatments and more lines lived 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 that it is ‘likely that long-term treatment with Botox can prevent the development of imprinted lines, not only by inhibiting the patient’s ability to contract the target muscle, but perhaps also by changing behavior .

‘With long-term treatment, the patient may become accustomed to having little or no need or ability to contract the target muscle, and may eventually ‘learn’ to stop even trying to contract it.

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

Wrinkles form when the 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 in shape, leading to the formation of wrinkles.

Botox injections are extremely popular. In 2022, more than 8.7 million cosmetic procedures were performed in the US. But the injections are not without risk.

The shots can cause bruising, swelling, and redness where the needle was injected. And the face may take on a frozen appearance, while also showing drooping eyebrows or eyelids.

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

A 2015 follow-up found that the Botox recipient twins had virtually no forehead wrinkles at rest

The Botox-treated woman had more superficial wrinkles around her eyes and mouth than her sister

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