Abstract

Botulinum toxin (BTX) injections reduce muscle mobility and are commonly used to treat the appearance of glabellar frown lines. Research shows that this cosmetic treatment leads to a reduction in depression. This reduction is consistent with the theory of embodied emotions because patients have a reduced ability to frown and so receive less negative feedback associated with this action. The current research explored this effect and three further hypotheses for the effects of cosmetic BTX injections based on embodied emotions. It was hypothesised that treatment of crow’s feet (or laughter lines) would reduce mood as patients’ Duchenne smiles would be impaired. It was hypothesised that facial BTX treatments would impair emotional expression recognition because the ability to mimic emotions would be reduced. Finally, it was hypothesised that, as BTX treatments prevent facial expressions associated with sexual excitement, sexual function would be impaired after treatment. Twenty four BTX-treated and twelve matched participants (all female) were tested before and after treatment. Results found that BTX treatment of laughter lines was associated with increased depression scores. Further, BTX treatment was associated with reduced emotion recognition ability and sexual function. The current results add to our knowledge of the psychological effects of injections of powerful neurotoxins and broaden the scope of the embodiment of emotions.

Highlights

  • The reduction of facial wrinkles using injections of botulinum toxin (BTX) has become a staple of the aesthetic treatment industry

  • The most studied psychological effect of Botulinum toxin (BTX) treatments has been the change of mood that results from the treatment of frown lines

  • There have been a number of randomised control trials (RCTs) demonstrating the robust effect that BTX treatment of frown lines has on depression[6,7,8,9,10,11]

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Summary

Introduction

The reduction of facial wrinkles using injections of botulinum toxin (BTX) has become a staple of the aesthetic treatment industry. The common explanation for the effect that BTX has on mood derives from the facial feedback hypothesis[12] This theory suggests that forming a facial expression strengthens the internal feeling of that expression. Due to the social mimicry of emotional expressions, this means that fewer people will frown back at the person, which could have an overall positive effect on mood While this alternative explanation is possible, evidence against it comes from the demonstration that BTX treatments affect the activation of the amygdala during a facial mimicry exercise[23] and so even outside of a social context, BTX is affecting the processing of emotions

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