Can the use of Botox affect your emotions?

A new book, 'The Face of Emotion: How Botox affects our mood and relationships', by American Dermatology Surgeon Eric Finzi explores the concept that botox injections can not only improve the appearance of lines and wrinkles, but can improve mood and relieve depressive emotions.




Finzi believes our emotions and feelings start with the face, the expression of the face such as frowning or smiling. He believes that simply by changing the way the face moves or contracts can have a direct effect on the persons emotional state.


He discusses how patients with depression have improved when work has been done to change the way they move their faces such as stopping frown lins with botox injections. He describes positive improvements in not only mood, but social interaction and general wellbeing.


He purports that the alteration of the corrugator muscle, for example (which causes frown lines), actually interrupts a feedback loop in the brain. A tense, folded brow feeds back to the brain that the person is angry or sad. Interrupting this feedback loop interrupts the cycle of emotion, improving the facial expression and in turn producing a more welcoming interaction between peers.


Finzi also adds that he feels the results of botox i.e. 'looking better' are not the main reason why he has seen improvements in patients, he believes the key is this feedback loop interruption and subsequent improved social interaction which are responsible.


We, hoever, are more sceptical. Particularly as Finzi adds an example of when a patient 'stopped taking Prozac' after having botox as it improved their mood so much that they felt they no longer needed it!


I would never advise anyone to stop taking a prescribed antidepressant independent of advice and supervision of their GP. I also feel the key issue in this whole debate should be about evidence. Currently there is simply not enough rigorous and tested evidence to prove beyond reasonable doubt that botox injections improve depression or lift mood. The majority of studies look at small numbers of patients or are anecdotal.


However, we have witnessed first hand a relative overall improvement in confidence, particularly in patients with a 'problem area' not just those who 'want to look younger'. Treatment and resolution of problem areas such as a deep frown line can alleviate a patients social anxiety about their appearance and improve confidence, but the absolute reason underlying is not always clear and further work and studies need to be undertaken in this fascinating area!


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