Cosmetic treatment with botulinum toxin type A injections is the top non-surgical cosmetic procedure in the U.S. Many patients are beginning treatment at a younger age to prevent the development of facial wrinkles associated with aging. However, there is limited data to support the use of prophylactic botulinum toxin injections. Patients beginning treatment at a younger age have fewer wrinkles requiring fewer units to treat, which reduces the overall cost of treatment. Patients also maintain higher levels of self- esteem by preventing or delaying the onset of facial wrinkles that can negatively impact their appearance. This study proposes that patients receiving botulinum toxin injections at a younger age (< 35) will have higher satisfaction with treatment outcomes. By demonstrating an association between starting age of injections and patient satisfaction, this study aims to provide merit for clinical trials studying the effectiveness of prophylactic botulinum toxin injections for cosmetic indications.