A pair of identical twins have showcased the outcomes after one of them consistently received Botox treatments, while the other opted to remain more natural over nearly two decades.
William J. Binder initially published study findings in 2006, tracking the progress of the 38-year-old identical twin sisters as one underwent Botox injections in the forehead and between the eyebrows two to three times annually for 13 years.
The other twin had experienced Botox only twice in similar areas, once in 1999 and again in 2003.
Binder revisited the study in 2012 to further explore Botox’s effects when the twins reached 44 years old.
Botulinum toxin, commonly known as Botox, is administered through injections to block certain nerve signals that cause muscle contractions.
The toxin temporarily inhibits muscle movement, making it popular for relaxing facial muscles that cause frown lines, ‘crow’s feet’, and other wrinkles.
Botox also has therapeutic applications, such as treating neck spasms, sweating, and preventing migraines.
Photographs taken before and after the treatments highlighted noticeable variations in the twins’ facial features, as they adopted a neutral expression for the images.
By 2006, Twin 2 had received at least 26 Botox treatments since she was 21.
In the photos, Twin 2 (right) displayed smoother skin and less pronounced forehead wrinkles, whereas Twin 1 (left), who had limited Botox exposure, showed deeper forehead lines and visible ‘crow’s feet’ when smiling.
The study’s follow-up, conducted almost 20 years after Twin 2 began regular Botox injections, highlighted further distinctions between the sisters.
By age 44, Twin 2 (left) had developed some wrinkles around her eyes and mouth, yet they appeared less severe than her sister’s.
Twin 1 (right) also seemed to have a fuller jawline, although it remains uncertain if Botox played a role in this.
The twins had differing living environments, with Twin 1 residing in Munich, Germany, and Twin 2 in Los Angeles. However, both worked indoors, maintained active outdoor lifestyles, and consistently used sunblock for skin protection.
Neither twin smoked or underwent laser, light, or skin-tightening treatments, with the study noting: “Regarding the aesthetic quality of their skin, consistent long-term treatment with onabotulinumtoxinA [Botox] seems to be the only major difference in the lives of these twins.”
Binder’s assessment suggested that prolonged Botox treatment could aid in preventing imprinted lines by targeting muscles and modifying behavior.
He stated: “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.”