Botox: Does Looking Younger Come with a Psychological Price Tag?

A cursory look around Los Angeles would suggest that Botox is as routine as its less invasive counterparts the blowout and the manicure. Perhaps not a surprise in a city that eulogizes youth and beauty. But while there's no doubt of the popularity of flocking to the needle, the jury is still out on the psychological effects of this injectable medicine. 

In a recent study out of the University of Southern California, it was found that due to frozen facial muscles, botoxed participants were unable to mimic the facial expressions of those they interacted with. Unconsciously imitating another's expressions sends a signal from the listeners’ face to their brain, enabling them to interpret the other's intended meaning. When this ability is impaired, the capacity to perceive others' emotions is impacted. In the study, women with Botox had increased difficulty interpreting both positive and negative emotional expressions, compared to their non-Botoxed peers. Although extended relational studies have yet to be done, with a little imagination we can foresee the potential downfalls of being in a relationship with someone who is not able to consistently decode our emotional expression. 

Perhaps the greatest implication of an inexpressive face is its impact on child development. The dual trend of increased Botox and higher child-bearing age could also affect babies' social and emotional development. Mimicking the facial expressions of the primary caregiver is crucial for two reasons: firstly, baby learns about emotions and social interactions through imitating the primary caregiver; secondly, baby develops his sense of self from feedback from the caregiver. We know from clinical experiments that when a baby can't get a positive emotional response from his caregiver, he quickly moves to a place of distress and nervous system dysregulation. Over time, repeated experiences of this kind negatively impact brain chemistry. And what of tone of voice and content as part of communication? Yes, these can somewhat compensate for lack of facial expression, but up to 80% of our communication is non-verbal. It is too early to say what the long term effect of Botox in the infant-caregiver relationship is, but we do know what happens when people lack communication skills and have a poorly developed sense of self. To view a short video of the Dr Edward Tronik’s Still Face Experiments, which show the impact of lack of facial expression and interaction on baby.

With mounting evidence on how Botox impacts relational quality, we are left to wonder if it has any redeeming psychological features. Enter Dr Eric Finzi who for almost two decades has been studying Botox's effects on mood. In his recent book, The Face of Emotion, he shares his research on the use of Botox, particularly his findings that Botox’s inhibiting of depressed patients' frowns improves mood. These are dramatic findings that suggest that facial expressions, rather neurotransmitters in the brain could be the driving force behind our emotions. The idea of inhibiting negative facial expressions as an antidepressant is radically different to any other intervention currently available.

The observed effects of Botox seem to make a case for and against. How about you? Does Botox affect your mood and relationships?