In the offices of New York plastic surgeon Daniel Maman, MD, a lot of patients come in wanting a “certain look”—something very specific for their face or body that, sometimes, simply isn’t doable.

Dr. Maman and his partner estimate that “about 50 percent” of patients have to be turned away because their “expectations are unrealistic,” and it’s a move that’s not just limited to plastic surgery inquiries.

“For Botox, we turn down some people, but this percentage is lower than what we turn away for invasive procedures. We turn them away because they are too young, they don’t need it or if they have a facial issue,” he says. “For example, men have a specific brow feature that requires their brow muscles to open up their eyelid because men have shorter upper eyelids. For something like this, we aren’t trying to take people’s money that can’t have it done.”

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So why would people get anything done if they don’t need it? The answer is pretty simple: “Getting Botox is definitely a trend. But, I don’t think it’s a fashionable trend for women under the age of 25. I think once patients hit late 20s, early 30s, there’s definitely a trend,” Dr. Maman explains, stressing that there’s no set age limit for neuromodulators, although there are definitely factors to consider before counting yourself as a good candidate.

“There’s no absolute age limit. If a patient comes in with facial asymmetry, where one side of the faces looks a little different that the other because of muscle issue, then I would give a patient Botox starting at age 17. But, if it’s purely for cosmetic reasons, there’s no reason for an 18-year-old to have Botox.”

Greenwich, CT, dermatologist Kim Nichols, MD, says there’s no denying that neuromodulators (including Botox Cosmetic, Dysport and Xeomin) are getting a lot of buzz, which, in turn, means a lot more patients come in and ask for it or want to know more about it—even when they aren’t 100-percent ready for it.

While she says she will “never turn a patient away,” she does say that, when Botox isn’t the right solution, it’s her job to create a regimen and treatment plan to address a patient’s skin care goals, and urges anyone who is even remotely interested in injections to see a board-certified plastic surgeon or dermatologist for a consultation. “They will help guide you on whether you are a good candidate, and if it’s the best treatment for you based on your goals.”

The bottom line, Dr. Nichols says, that when you are ready (and the right candidate) for Botox, it can work wonders. “First and foremost, Botox is safe and actually has the highest patient satisfaction rate of any cosmetic treatment as reported by Allergan, but in order to love your results, we want clients to feel good about their treatments. So, someone who doesn’t feel comfortable with injectables yet, I usually wait and educate them on their treatment plan before they have the treatment done if it is right for them. Of course, clients that are not a candidate are those allergic to any botulinum toxin product, have a skin infection at the planned site of injection, pregnant or breast-feeding, or have a chronic infection or illness.”

“My patients understand that if they keep up with their anti-aging treatments and start their anti-aging routine at an earlier age, the less they will need to do later to have a graceful aging process. The average patient has a lot of access to impressive before-and-after photos, as well as cosmetic education that supports Botox being a safe and effective treatment to appear youthful without being overdone. Everyone wants to look the best for their age, and Botox is highly recommended for doing just that.”