The pressure to look young in Hollywood is intense, even when you're actually young. 

In May Kim Kardashian nonchalantly told Nightline she hadn't had any plastic surgery done, but admitted that of course she had used Botox.

Kim's 29. 

In January, reality television star and aspiring actress Heidi Montag, 23, was on the cover of People Magazine touting the 10 cosmetic procedures she received in one day, including Botox injections. 

Other young actresses who have been rumored to have gotten injections include Megan Fox, 24, Lindsay Lohan, 23, Hilary Duff, 22 and Jessica Simpson, 29. 

"I don't know why they don't just say they do it, because everyone else does it too. I see maybe four or five well-known actresses a week who insist on coming through the back door because they don't want anyone to see them. And half of those are under 30," says Los Angeles-based cosmetic dermetologist, Dr. Simon Ourian, M.D. His youngest Botox injectee? A 17-year old model.

"I think a lot of women feel the pressure to look younger and be at their best. When the rest of the population seems to be younger then you have no choice but to compete," he told FOX411.com.

Botox is a toxin that when used in small doses attaches to nerve endings to prevent the release of neurotransmitters that cause muscle movements. According to the American Society for Aesthetic Plastic Surgery, more than 2.5 million Botox injections were performed in 2009.  

There are no significant dangers to starting Botox as a teenager, but starting the injections too early could lead to the treatments not working later in life when these actresses might want to start hiding some more serious wrinkles.

“No long term side effects have been reported. Some studies show that some people develop immunity to it though," explains celebrity plastic surgeon Dr. Michael Fiorello. "Over time Botox doesn’t work as well as it does in the beginning, so after a long time of getting the injections, its doesn’t have the same effect as it did in the beginning."

And casting agents are seeing so many paralyzed pouts that some say they're now specifically seeking out young women who haven't had an abundance of procedures done.

"We want to cast beautiful women. If Botox does that, then good for them. But if I can tell straightaway that an actress has had excessive amounts of Botox treatments, then I will probably move onto the next woman," one casting agent explained. "I don't want to use an actress who doesn't look like a real woman."

Some young women are getting treatments done because of their hard-partying lifestyles. 

"If someone told these girls to just get back to basics, don't stay out partying all night, don't drink, don't smoke, and don't do drugs, then they wouldn't need these quick fixes for their face," said casting agent Toni Cusumano. 

And it isn't just casting agents who are turning against these Botox babies, its also the fans who see their movies, watch their television shows and buy their products. America wants to see women who are beautiful, but who also have an attainable beauty, explains Cult of Celebrity author Cooper Lawrence.  

"These women are not relatable because most Americans at that age are not as vain as New York and Los Angeles twentysomethings are," said Lawrence. "When a twentysomething talks about plastic surgery or Botox, most Americans either roll their eyes or feel pity for the girl for having such low self-esteem. It isn't age appropriate."

 The young face of Botox

Young women in their 20s turn to shots to prevent wrinkles from forming.

When Natalie Neal, 27, looks in the mirror she sees one faint line across her forehead. She knows no one notices but her, but “when I’m 40 and have a huge line across my forehead they’re going to notice.”

That’s why before her wedding last summer, Neal adopted a beauty routine from her 50-year-old mother – Botox.
And Neal knows, as many a mother has warned her young daughter about shaving her legs, once you start injections of the wrinkle smoother, you really can’t stop.

“I want to look and feel young as long as possible,” says Neal, a speech therapist who paid $88 for four quick injections across the forehead. “I feel confident I’m doing my part so I don’t have very defined lines.”

Doctors who administer Botox say the sooner a patient begins the paralyzing facial muscles, the less opportunity they have to thicken and form deep lines and wrinkles that are harder to erase. The majority of Botox consumers are women between 35 and 50. They underwent 1.5 million injections last year, according to the American Society for Aesthetic Plastic Surgery.

But Botox regimens can start much younger, particularly in celebrity-influenced Southern California.

Patients 19 to 34 accounted for 14 percent of Botox users nationwide. While local medical practices say their youngest patients are typically in their mid-20s, a small number of high school girls go in for a shot before prom.

Some social critics worry about the ever-rising standards of beauty for young women combined with treatments that are increasingly invasive and expensive.

“It’s sort of a quest for perfection now,” says Julie Albright, a USC sociology professor and an assistant producer of the cosmetic surgery documentary “Made Over in America.”

“Actresses and models have to be more and more flawless because of the increasing resolution of our television sets. Research shows young girls and women into their 20s look to the media for role models. It normalizes it for a younger and younger crowd. Earlier generations were interested in creams and Oil of Olay. These girls are interested in Restylane and Botox.”

Jennifer Roe, an office assistant at Dermfx in Sunset Beach, started using Botox at 21 or 22 when she began working at the medical clinic that offers Botox seven days a week. She wants to fend off fine lines before they become more intractable wrinkles.

“I love the way it looks, so now that I’ve done it, it’s addicting,” says Roe, 24. “I’m always going to have to do it. It kind of gives your eyebrows a little lift and it makes your forehead really smooth.

“I’m not really going to need it as much when I’m older because a lot of those muscles aren’t going to be used.”

In one study on the preventive use of Botox, a Beverly Hills plastic surgeon compared two identical twins. One sister started Botox at 25 and the other did not. At 38, the “untreated” sister had noticeable lines while her sister did not, according to the doctor’s study and photos, funded by Irvine-based Allergan, the maker of Botox.

Roe is open with her friends, though some people are shocked that she would use a wrinkle treatment at her age.

“I don’t really have a lot of crow’s feet or anything yet. I’m really cautious about not being out in the sun,” she says. “I might be lucky and hold off (on other areas) for a few years.”

Erin Alonso, a nurse practitioner at Dermfx, says she notices young adult daughters influencing their mothers to try Botox, rather than the other way around.

“I used to be kind of opinionated thinking they were maybe too young,” Alonso says. “I’ve been doing this for 10 years and you might as well preserve what you have.

“You do see a lot of daughters dragging their mothers in. I think younger women might be more open to it because we’ve kind of grown up with it.”

Alonso says a small number of teens have their parents sign consent forms so they can have Botox for flawless prom pictures. Other Botox injectors say the mid-20s is the earliest they treat patients for facial lines.

“If they’re old enough to know about it and to understand and it’s a reasonable expectation, then it’s totally reasonable to do it,” said Dr. Renee Cobos, a Fullerton dermatologist.

As for teens, she says she would try to talk them out of it.

“It’s just a little excessive,” Cobos says.

Neal’s Irvine doctor, Susan Davoodifar, takes a special precaution with her younger patients, asking if they plan to become pregnant or are breastfeeding. Cosmetic use of Botox is not recommended during pregnancy and it is unknown if the drug is excreted in breast milk.Neal, who tried Botox before getting married, notes that most of her pre-wedding preparations – waxing, manicures, facials – have fallen away.“This is the one thing I’ve kept up,” says Neal of Seal Beach. “Look at my nails now. You sort of pick and choose.”

source: http://www.ocregister.com/ocregister/homepage/abox/article_2080995.php