Let me describe a beautiful friend of mine. Blonde waves to her waist, strong jawline, an astounding talent for holding eye contact, and an equally astounding ability to pull off tulle and eccentric headwear. Last summer, I was running early to meet her and she arrived apologizing. We hadn’t seen each other in months, so we had a lot to catch up on, and she didn’t want me to think she wasn’t invested in whatever drama I was about to regale her with. She was coming from a Botox injection, so she wouldn’t be able to emote much, she said. She laughed, and her smile almost reached her eyes.

A few months later, I was home for Thanksgiving when a friend from childhood, who is in her early 30s like me, made a similar pronouncement — apologizing for her Botox-limited range of expression, which she worried might be mistaken for emotional stoniness. And when, soon after that, my 28-year-old sister accused her best friend of seeming apathetic at her birthday dinner, the friend replied with surprise — evident in her voice, if not her face. Didn’t my sister remember that they’d been on FaceTime earlier that day, literally during her Botox appointment? That night, I anxiously searched my face for burgeoning lines.

It’s not that I hadn’t expected the tide to come in: In the past decade, Botox had gone from an expensive practice mostly embraced by people also interested in invasive plastic surgery to a routinized and subtle intervention, marketed to anyone with a skin-care regimen. It’s cast not as a precursor to the operating table but as another part of normalized beauty maintenance, as low stakes as a blowout or a wax. Injectables are, according to this magazine, a seemingly inevitable part of aging for women “in the New York City metro area” with any “disposable income.” Stroll downtown Manhattan and you might pass a trinity of tweely named chains specializing in facial injectables (home to Ject, Peachy, and Plump outposts) — medical spas where you can book, get injected, and pay in the span of your lunch break, not to mention return to your desk without even a Band-Aid.

In 2024, more than 9 million doses of Botox and neuromodulators under other brand names (Dysport, Jeuveau) were injected in the U.S., and the debut of ostensibly preventative “Baby Botox” coincided with a 71 percent uptick in patients injecting it in their 20s, alongside a 75 percent increase in patients 19 and younger. Botox’s manufacturer, Allergan, is explicitly positioning preventative Baby Botox — regular doses of the chemical preemptively injected in areas where wrinkles are expected to develop, most commonly to avoid “laugh lines” and “angry 11s” between the eyes — as the future of the drug in a campaign that frames the chemical as a “champion of authenticity.” My mother’s friends, injecting Botox in their 40s and 50s, were trying to reverse aging. My own friends were attempting to prevent the process from ever getting started, engaging in a practice of self-preservation that once sounded science-fictional but is now seen as not only realistic but requisite for women who don’t want to “let themselves go.”

I shouldn’t have been surprised, and yet. I was raised on aughts-era tabloid vilification of women with frozen faces, Botoxed celebrities mocked for their presumed idiocy, vanity, and, worst of all, legibly desperate attempts to embody a beauty standard they were aging out of. My friends and I had been trained to imagine “aging gracefully” — admittedly its own kind of fantasy. We read feminist literature, many of us were in recovery from eating disorders we saw as downstream results of the very same beauty standards that devalued women for aging, and we feared becoming women whose relationship to their own image was, with each injection, increasingly removed from reality. Friends’ casual mentions of Botox felt startling but also provoked a familiar sensation: of missing a memo or being excluded from middle-school strategy sessions. I remembered the first time the girls I sat with at lunch pushed their trays away and asked why I wasn’t dieting too, sleepovers where I learned that everyone else had been wearing push-up bras for months.

That night at my sister’s birthday, I felt, for the first time, the impulse to reexamine what I’d always assumed was yet another form of learned self-harm. What if interventions like Botox and laser treatments were, instead, a style of self-care, maybe even a display of mature consideration for my long-term health? Resisting aging might be smart, safe spiritually as well as physically, not the sort of capitulation to an oppressive standard I instinctively understood it to be. Or maybe paying to put a paralytic poison in my body was, if not exactly what it sounded like, not entirely dissimilar from what it sounded like?

Those girls at sleepovers and in the cafeteria were playing war games, planning exfiltration operations to save each other from judgmental stares and cruel comments. Now, my adult friends were taking it a step further, crafting investment strategies and formulas in search of the professional and social success that ostensibly came with the appearance of eternal youth. These were women I admired by all intellectual and emotional standards. They were also the women who’d thrown me life rafts in earlier eras, when I’d felt like I was drowning in the pressure to shrink my body, even at risk to my health. I wanted to know how, or if, their decisions around anti-aging interventions fit into their political ideals, whether these practices felt like betrayals of their feminism or something closer to an evolution or reinterpretation. So I began asking them.

Ariana*, the 33-year old doctor who apologized to me, first got Botox after “a very chic, slightly older friend,” one whose “fresh and rested” visage sparked envy, revealed that the chemical was “her secret.” She’d been purchasing it privately for years. “I remember thinking people getting Botox before 30 was psycho and still do. But then again, I got it at 30,” she told me.

Discussing the chemical with friends her age felt reminiscent of conversations held in low, nervous voices during early adolescence, “when you hadn’t gotten your period and weren’t sure if your friends had.” The procedure felt like a feminized rite of passage, approached with the “nervous, naïve vibe” of a first-time tampon shopper. Cora, a 30-year-old teacher, agreed that an odd mix of both transparency and secrecy orbited the subject. Turning 28, she said, inaugurated the “era of sharing promo codes” for injectable clinics among her women friends, accompanied by an aversion to actually attending appointments together. Part of the appeal is their favorite clinic’s remoteness. Inaccessible by train, it demands an Uber trip, and, she said, “you don’t tell a soul.”

One friend told Cora that she explicitly linked her Botox use to her struggle with a “horrible eating disorder,” casting her fears around aging as contiguous with her larger demons around meeting beauty standards. But lately Cora has observed more friends conceptualizing their anti-aging practices not as health problems but as medical solutions. She described one friend as “TMJ-washing” her regular Botox injections, relying on the off-label prescription of Botox for teeth grinding to do so. One friend told me that learning the lines that ran from her nose to the sides of her mouth were called nasolabial folds transformed the way she understood them. What was once a feature now felt like a flaw: If it sounds like a disease, maybe it has a cure. Another observed a widespread “drift in beauty toward a medical ethos,” one occurring in the skin-care space too, which “makes Botox seem of a piece with everything else.”

The amount of research that informs beauty and anti-aging regimens can sometimes feel like “getting a Ph.D. in women’s faces,” as one woman put it, an avalanche of education “crowding out so much other information in my brain.” Caroline, a 31-year-old filmmaker, is familiar with feeling a bit like a mad scientist–cum–economist when she heads to the med spa. Before she began regularly receiving Botox injections and laser treatments, she performed exhaustive research online, pursuing subtle work with long-term results, procedures that would foster “sustained beauty” rather than a quick fix. She purchases Botox injections regularly, along with laser treatments and other noninvasive procedures. She is resistant to filler and more invasive surgeries: Her worst fear is the facial uncanny, when “you’re no longer referring back to your original anatomy, but you’re referring back to your most recent appointment.” All this effort incites a kind of cognitive dissonance — the procedures, and the amount of time spent on them, are “diametrically opposed to my politics,” she said. “I could literally be putting thousands of dollars in my Roth IRA, but instead I’m investing in this other way, hoping that being attractive for as long as possible is beneficial for my career, my social life, and the way I feel about myself.” Like Cora’s friend, she said this strategy is rooted in the reasons she has an eating disorder, a mind-set that admittedly “takes up a lot of time in therapy.”

Some women describe a FOMO-motored decision-making process that runs parallel to my sense of teenage exclusion. Of friends who look “amazing” post-injections, one woman said she can’t help but wish she could tell them, “You’re making it harder for me in a material way.” Caroline’s inner turmoil is driven not just by her individual decisions but by the aesthetic choices made by the other women in her life, the feelings sparked by a subtle shift in a friend’s face. She’s found herself disturbed by her own internal observations that friends look more beautiful after a procedure. Her mother, who once regularly got Botox but has since stopped, now has more wrinkles, and when gazing at her, Caroline recently found herself thinking she may have considered her face more beautiful during the era of her regular Botox appointments. “No matter what you want to believe in your brain, you’re like, ‘Younger looks better.’ What does it mean,” she wonders, “to see someone you love’s face change and be like, ‘That’s better’?”

After her own early Botox experiments, she received compliments from friends and, once she revealed what she’d done, requests for referrals. The attitude was, “You’re someone whose politics I align with, and your work is good, and I want to do the same thing,” she told me. Now that multiple friends share her practitioner, she worries she might be “pulling my friends into what is ultimately the greatest pyramid scheme of all time” and compared her own approach to aging to playing the victim in a sting operation. The med spa is a trap, one she is “willfully walking into saying, ‘No cuffs, I’ll get into the back of your car.’” But there are other ways to implement her politics around beauty, she said, including transparency around the financial and existential sacrifices required to conform to current standards — thousands of dollars spent at the med spa annually, accompanied by the resurgence of thought patterns she recognizes from her disordered eating days.

In recent years, her approach—solidarity-coded information sharing, a conviction that lying to your sisters about the time, money, and energy required to conform to misogynistic standards, is the real feminist crime — has gone mainstream. The New York Times praises Kris and Kylie Jenner’s refreshing honesty about the work they get done as “ushering in a new era of beauty culture,” while Harper’s Bazaar deems Kylie a “true ‘girl’s girl’” for offering the details of her breast implants to her followers, concluding that “as women, we’re all subjected to the same societal pressures; the least we can do is speak openly with one another about it.” The last decade has wrought a strange rhetorical convergence of body positivity and pro-plastic-surgery narratives. Finding beauty in your folds and flaws is suddenly a strategy no more or less feminist than the decision to boost your confidence through elective surgery, never mind that the former was predicated on resisting misogynistic beauty standards and the latter on sacrificing one’s time, money, and safety to better approximate them. All that’s demanded of the ostensible feminist today is that she leave her girls a how-to manual.

Cass, a 31-year-old friend, said that while she sees her Botox purchases as “a failure to enact the political convictions that I hold,” that is ultimately “a pretty common experience if you’re living in the U.S. in 2026.” She described disengaging from other practices she politically disavows, like DoorDash delivery, as difficult but feasible; a similar exit strategy from the beauty-industrial complex isn’t. She was indoctrinated into our beauty standards so young, and has been relying on her beauty practices and the affirmation that comes with conforming to certain standards for such a vast swath of her cognizant life, that she said it felt like her “political-conviction muscle” around the issue had atrophied. As one 29-year-old friend of mine, who has not yet purchased Botox but predicts she one day will, put it, her self-consciousness around her fine lines does incite “sadness because I do ultimately think it is unfeminist to want to look like a baby.”  But while she is “opposed to attempts to invent feminist rationales for Botox,” she wondered whether it’s really fair to make it “our personal responsibility to look fucked up so that we can uphold our values?”

Nieve*, a professor in her early 40s, described arriving to her late 30s after performing “self-worth jujitsu” around beauty throughout her 20s, finally reaching her “ideal relationship to beauty, which was to think about it as little as possible — to become the rarified intellectual who didn’t give a fuck about beauty and was beautiful without wanting it or putting effort into it.” Yet faced with the “horrifying specter” of aging, she found herself reckoning with her “primal fear around beauty,” not that she resembled a wizened crone but that her vision of herself did not align with what the world saw, that there might, instead, be a “horrible, embarrassing, humiliating disjunction.”

Another friend, freshly 30, first purchased Botox on a whim at the behest of a facialist. She describes herself as a “holistic-seeming, granola-adjacent person,” she said, “so no one in her life would assume” she’d be a Botox customer. No one noticed, and she didn’t tell her boyfriend or the vast majority of her friends. She enjoyed having a secret. Heading back to the aesthetician for a second round, she found that part of the allure was the sense of liberation. This was something that existed just for her, outside the hyperconnectivity that defines our moment. “It was so fun,” she said, “for no one to know where I was — like being on an airplane and not turning Wi-Fi on.” The physical experience of Botox recalled another adolescent high. She described the sudden tightening as akin to the teenage triumph of “zipping myself into jeans that were just a little too small.”

But she hasn’t sat down in an injection chair since that second round. She noticed herself trusting these women who held her face in their hands. She says she let them convince her to get more Botox than she had previously, in more areas, and she could imagine herself following the lines their fingers drew on her face right off a cliff. Beyond that, she told me, she knew that continuing to receive injections would eventually make the practice apparent to the people in her life. That admission “changes who I seem like as a person,” she said, “which is the ultimate sacrifice.” Implicit in the decision to inject Botox is the fact “that you’ve spent enough time looking at yourself and being dissatisfied that you’ve taken action,” she said, which, for her, raises the more intriguing question of what else you might be doing with your time.

In 2022, the writer Haley Nahman mused on the media’s tendency to report solely on the experiences of women who choose to undergo cosmetic surgery, that despite understanding “the desire (even the need) to address the feelings of women who get work done,” she couldn’t “help but feel that centering them in the broader debate around cosmetic procedures is a painfully bourgeois approach” and one that “preserves the status quo.” One 37-year-old editor said her friend group had broadly rejected injectables. “Botox is represented as something that all professional women do, and that’s just not true,” she said. “There are a lot of people who are not interested — for feminist reasons, for wanting to age, for fear of the fact that it’s a poison, it’s expensive, it’s time-consuming, it’s boring: There’s every reason not to do it.”

Some of those reasons are more obvious than others. Botox has proved physically safer than filler, but there are certain risks not disclosed at the med spa. So much of our emotional education occurs through microexpressions we don’t consciously forge, or explicitly notice in others, and there’s evidence that, in limiting how much a person can emote, Botox could also limit our ability to recognize and name what emotion another person is expressing and decrease the overall intensity of emotional experience. (One study from 2018 discovered that orgasm was more difficult to achieve and, when it was possible, less “satisfying” for women with Botox.) In the case of Baby Botox, there are some theories that those side effects impact young women’s capacity to mature accordingly. Dermatologist Shereene Idriss recently warned Marie Claire readers against preventative Botox, arguing that someone who starts Botox at 21, and follows the recommended three-month-upkeep schedule, may stunt their emotional growth along with their physical aging. That patient is “going to have no movement, no sense of self, no ethos of who they are,” she believes.

At the tail end of her 20s, Allie Rowbottom, a novelist and then-Ph.D. student, lost her mother. The absence instilled a yearning: to “prolong girlhood,” to remain her mother’s daughter rather than become an adult woman in a body that would likely age past the point her mother got a chance to. She ended up in an injectable clinic. When the Botox set in, she couldn’t frown — in thought over books or in mourning — and she felt “like someone had just put a weighted blanket on me: All this trouble lifted off my face, and I felt less troubled.”

Allie didn’t tell her friends or partner about her experiments with Botox and filler. I wondered whether stultifying her ability to show emotion offered her privacy, the chance to grieve in solitude when the people in her life, and our culture at large, expected to see her distraught. Maybe it even helped her actually feel less and gave a girl grasping at sentimental agency a foothold. But over time she grew frustrated with herself “as a feminist and an intellectual” and regularly cried in the car after Botox appointments, imagining her mother’s disappointment. She decided to write her way through the self-contempt — through personal essays on her own journeys across the medicalized beauty Rubicon as well as in her novel Aesthetica, set in a near future when plastic-surgery addicts can receive one operation to reverse everything they’ve ever gotten done. That process clarified the tyrannical nature of the “forces conspiring” to convince her to hate herself. “For better or worse, I feel better about myself with Botox,” she told me, and she is no longer interested in “punishing myself” for choices she makes to improve her quality of life in a world that all but demands them. Women have long transformed the trappings of femininity designed to corset us into costumes and coping mechanisms, which is perhaps why we keep mistaking survival strategies for self-harm or trying to convince ourselves there’s a difference.

Like Allie, I’ve often felt the urge to expel overwhelming emotions, along with the physical flaws that sometimes provoke them. Even the women who avoid the injectable chair told me they were “terrified of aging,” that certain friends who got work done looked, admittedly, fabulous, and owned up to uncertainty around whether their resistance might crumble in another decade or so. One 42-year-old woman described her shock at just how “desperately bad” facial aging made her feel — a situation she first understood as a “painful irony” but has come to recognize is “not a coincidence at all.” As a woman ages into her early 40s and feels, finally, “like a solid person,” she said, “your external casing starts to melt off.” Language of liquefaction, melting, and leaking came up often in women’s descriptions of aging — a lingua franca that renders Botox, a paralytic, perhaps uniquely alluring. But the dread of not looking like ourselves, or rather the aspiration to continue looking like myself, despite the passage of time, is a denial of the fact that faces change as the people who peer out of them do.

The idea of approaching the future of my face with the same curiosity I bring to the future of my personality feels less like an obviously available choice and more like a fantastical daydream, but it’s also one some women are actively living. There is a woman I’ve admired my entire life, a wispy, Waspy woman who hosts parties with panache, bikes crosstown in the rain, wears her hair in a high ponytail, and does an incredible impression of Elizabeth Hardwick. At age 69, she’s never received any cosmetic work and wears her wrinkles like she wears the faux-leather pants she showed up to an event in recently. She told me her resistance to anti-aging interventions is both “philosophical and financial.” She’s never thought of “a wrinkle as something bad” and described the Botoxed faces of friends causing her to “rear back because it takes away the person’s face.” However, she admitted to “reacting poorly” when she sees someone who could plausibly be described as “ravaged by time,” a category that recently included herself. On a recent cold day, she looked in the mirror after a walk on the seaside and saw “5,000 lines that went all the way down my cheeks.” She found herself entranced, “looking and looking,” thinking “Jesus Lord, I didn’t realize I had gotten so advanced. It hits your vanity, no question, and it’s not as though I don’t care. It is: I do care, I am getting old, and this is what it is.”

“When I see women my age or older with visible wrinkles and dimples and other signs of aging they haven’t troubled to reverse, something in my body genuinely loosens,” Nahman told me. “Their self-acceptance functions as a kind of permission to accept myself in turn. I like having signs on my face of aging, and helping be part of a chorus that normalizes that.” I want the volume turned up; I want to learn the melody. I don’t know exactly what I’ll do as I age, but I’m certain of one thing: I’d like to talk to you about it, face to face, in a loud room with good lighting and no mirrors.

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