Proactive Aesthetic Strategies: Evaluating the Preventive Role of Botulinum Toxin in Facial Aging

Background: In recent years, botulinum toxin (BoNT) has been increasingly employed not only as a corrective aesthetic intervention but also as a proactive strategy to delay the visible signs of facial aging. This systematic review aims to evaluate the scientific evidence supporting the preventive role of BoNT in facial aging, focusing on its long-term effects, mechanisms of action, and clinical outcomes when used in younger, pre-symptomatic populations. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science databases. Inclusion criteria encompassed clinical trials and observational studies addressing the use of BoNT for proactive aesthetic strategies. Results: Evidence suggests that early BoNT application may reduce muscle hyperactivity, delay the formation of dynamic wrinkles, and minimize the development of static lines over time. Histological studies indicate a potential remodeling effect on dermal collagen. However, data remain heterogeneous, and long-term safety and efficacy outcomes are not yet fully established. Conclusion: Preventive BoNT injections represent a promising tool in the proactive management of facial aging. Further longitudinal, high-quality studies are needed to substantiate its role within evidence-based aesthetic protocols.