Botox Stunts Emotional Development – Really?!
I was interested in the press attention about Botox yet again this weekend, with articles in the Daily Mail and on the BBC. For those of you new to the concept of Botox, it temporarily blocks the communication between nerves and muscles therefore reducing movement in those muscles. We regularly use this in the face to decrease the muscular movements responsible for causing wrinkles, particularly in the upper face.
When I treat people with Botox my aim is not to remove all movement and expression, but to decrease it to a point where a crease doesn’t form but people are still able to demonstrate emotion. Unfortunately this isn’t everybody’s ethos, and the frozen waxy look has become all too common amongst celebrities. I find myself having to explain to my patients that we aren’t aiming to remove all movement – they are so used to seeing the expressionless faces many celebrities sport that they find this concept very difficult to understand.
In my opinion the best time to start having Botox is when the wrinkles are at a very early stage – where there is a hint of a line, but it isn’t engrained in the skin yet. In these cases regular Botox will effectively smooth the line out and will also prevent lines from becoming deeper. This point will vary from person to person.
The media attention this weekend centres around an article published in the Journal of Aesthetic Nursing claiming that giving Botox to under 25 year olds restricts their emotional development, yet it is fine in those in their late 30s who are already emotionally developed. My issues with this centre on the fact that I don’t agree with such a blanket approach to patients. I, for one, find the idea that I wasn’t ‘emotionally developed’ in my early 20s a little offensive. That isn’t to say I haven’t changed since then, but I was certainly able to understand and express a complete and adult range of emotions. I also know some older people who aren’t emotionally mature. I treat and approach every patient as an individual. As a competent professional doctor I am not only able to assess whether that patient has indications for a given aesthetic treatment but I am also able to assess whether they understand the treatment they are about to have and whether they can evaluate its impact.
Saying that Botox restricts emotional development also assumes that patients are being given Botox in the ‘freeze your face’ way I’ve discussed already. This is the wrong approach and is not one that most reputable practitioners use. If you can still frown, but don’t form those ‘11s’ in the middle of your eyebrows, you are still expressing your emotion. What is wrong with that?
For me the far more important issue is for people to research a good Doctor or Nurse to go to, who will spend time assessing their face, their indications and also explore why this is bothering them so much. If a young person has deep lines already then I spend time exploring why they may be ageing prematurely – Are they using sunbeds? What is their skincare regime? Do they smoke? The point at which to start Botox will vary between individuals. Personally the youngest person I’ve treated was a 24 year old who was extremely upset by her already deeply engrained horizontal forehead lines. I have also consulted several under 25 year olds who have wanted Botox but I have advised it is not the right treatment for them at this point in time, as they don’t have visible signs of ageing yet. I’ve also given all of them advice on how to look after their skin better to help them age better.
Will most under 25s benefit from Botox – no absolutely not, and in my opinion may actually make them look older than they are if they have no indications for it. However if a 24 year old walks into my clinic tomorrow with defined movement-related wrinkles then yes, I will treat them whilst also providing them with advice on why they have aged so prematurely.
Disclaimer: Please be aware that results and benefits may vary from patient to patient taking into consideration factors such as age, lifestyle and medical history.