Chasing the Clouds Away With Botox

April 14, 2015


iStockTHE MOMENT THAT did it: I was at the optician’s and caught a glimpse in the mirror. I was chatting with her, and smiling—but still scowling. I’m a high-strung sort, I knew my favorite accessory was a little black cloud, but I hadn’t grasped that it was a permanent fixture even when I felt chipper. (That my kids often asked, “What’s wrong?” while I was, say, cheerfully puttering around the house should have been a tip-off.) Since my attempts at greater serenity starting from inside my skull didn’t seem to be making a dent on what showed outside, I thought: maybe it’s time to try working from the outside in—specifically, starting with the dents chiseled between my eyebrows.

Almost a year after writing a piece about Botox’s effect on mood, I was finally overcome with curiosity about whether Botox could alter not just my scrunched brow, but the thrum of low-grade anxiety responsible for much of it. The studies I’d read used Botox to treat depression, but the principle jibed with decades’ worth of happiness-research findings: making your face look happier tends to make you feel happier, and not just because you’re pleased by the cosmetic improvement. For instance, people told to hold a pen in their teeth, which creates a smile like it or not, found cartoons funnier than did study participants forced to be sourpusses by holding a pen between their lips. (A friend even reported a trend among hip Manhattanites for starting the day with such pencil-clenching to promote a positive outlook.) So I set out to see if ironing out my brow could similarly spur a little serenity.

Even legendarily tightwad me thought better of going Groupon on this one. (A doctor needs no certification to inject Botox, and even purported credentials can be misleading–people can get “certified” online. The deluxe version sends you a foam head to practice on. I don’t know, when one of the potential side-effects is, y’know, botulism, I think I’ll play it safe.) So in early February, I placed myself in the well-credentialed hands of Dr. Tina West (a participant in the original clinical trials) of the West Institute in Chevy Chase and took five shots right between the eyes—well, actually, about a centimeter higher. Thirty units of Botox and a few pinpricks later, I was primed for my frown to be frozen out of existence, and maybe some chronic consternation with it.

Although it takes up to two weeks to take full effect, I went home and told my family what I had done. “You’re not going to be able to scowl?!” asked my husband. That’s the idea. “Ha! Her powers have been neutralized!” he crowed, while the kids laughed and laughed. “We don’t have to do what she says anymore! Her reign is over!” I secretly suspected that my powers would prove too great for mere botulinum toxin, but sure enough, over the next couple of weeks, I’d begin a slide toward default fretting, brow muscles commanded to contract, and…not so much. It’s very, very weird not to be in control of your face. Even once the full force of it kicked in, I could manage the slightest squeeze of muscles, and of course the at-rest wrinkles remained, but I could produce only a shadow of my former craggy crevices. I couldn’t help laughing, checking myself out in every mirror trying my damnedest to glower and seeing someone who looked confused, possibly mildly concerned, but far from cataclysmic. I loved that there were now limits to how dark my expression could be.

My daughter came home from college and midway through dinner, I referenced the great Botox experiment. “That’s what’s different!” she exclaimed. “I forgot you were doing that, and I’ve been sitting here wondering, what’s different? Did she pluck her eyebrows in some new way?” Part of what she was observing is a natural lift that I had not anticipated. As Dr. West explained, muscles throughout your body work in opposition, so you have muscles that pull your forehead down, others to lift it up. When you nullify the downward tug, it gives the upward freer rein. In rare cases, it’s too much of a good thing—the eyebrows arch into what’s self-explanatorily called Nicholson brows, and the doctor needs to tame those muscles until the dose can be adjusted next time around. For me, though, it merely resulted in a millimetric lift, not enough for a perpetual-3 to create a noticeable difference if you’re very familiar with my face. Whether it has made a noticeable difference in my outlook is more debatable.

As scientific experiments go, this one is ludicrous—a sample of one, no control group and observational bias to beat the band. Nonetheless, I swear, it has had an effect. As if to give it a good test, a couple of small-to-middling family crises arose toward the end of February, and I have been worrying all right—plenty—but not obsessing and perseverating to quite the degree that I would have otherwise.  While I recognize the huge potential for placebo effect, trading in my Resting Bitch Face for at least half of a Happy Face (the unimproved lower portion still sinks instinctively into grimness) does seem to be hampering the cycle of fretting and frowning—it feels more like I worry when I’ve got something to worry about, less as a matter of routine. True, I’ve regularly asked my family for feedback, and none of them reports perceived differences in my overall disposition (oh, like they actually pay attention to me anyway?). In fact, after some sleep-deprived snappishness directed toward my husband, specifically his snoring, he sulked, “Geez, I thought you were supposed to be all jolly and stuff now.” Hey, it wasn’t a lobotomy! But knowing that my brow is not perpetually lowered like thunderclouds—I’m aware of that, and it’s uplifting to know I look happier, even aside from what it’s doing to me subconsciously. It’s safe to say that any shifts in my psyche have been subtle, at best, but I don’t care what my family says—I say I’m more tranquil, goddamn it.

It’s too much to hope that one round of Botox can break me of a lifelong brow-knitting/anxiety-fostering habit. But if I keep at it, I may indeed find the results more enduring. “We know how long Botox itself lasts—on a woman, we usually use 30 units, which lasts on average four months,” notes Dr. West. (The more typical 20-unit dose lasts around eight weeks–reason to check the number of units someone’s injecting.) “But I get patients who report that it lasted much longer, which tells me that something changed how much they’re scowling even once the Botox wears off.” Indeed, studies have suggested that with repeated use, botulinum toxin may “have a persistent benefit even once the paralysis has reversed,” due perhaps to “dermal remodeling, slight muscle atrophy and behavior modification.” I may well commit to regular boosters. It’s very tempting; as Dr. West warned, not many people stop getting Botox. “It’s like once you dye your hair—you see the gray roots reappearing, and you think, Uh-uh! I’m not going back to that!”

Already, I’m certain that I’m able to create slightly deeper creases than I could a month ago, and I’m not happy about it—whoops, I mean, raise those brows, relax that forehead!–I’m totally chill! Besides, given the cost, it might make more sense instead to finally try the meditation I’ve been meaning to get to for 30 years. Or just stick a pencil in my teeth every morning.

–Catherine Clifford

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