Did the Pandemic End Botox Stigma Once and For All?

Like so many of us, I’ve spent the pandemic gazing into the computerized glaze of my own bedraggled face. And while I’ve used Botox since my mid-20s, thanks to the early-onset brow creases that run in my family, I felt a new urgency around getting those injections as the world around me crumbled. The truth is, I would like to look better. I would like to feel better. I would like to believe looking better will make me feel better. And, it turns out, there might be something to my theory that adjusting my appearance might adjust my mood. The facial feedback hypothesis posits that by treating the wrinkles or sagging that make us feel tired and sad, we appear less tired and sad to others, and in turn, feel less tired and sad ourselves. Not only that, but a survey conducted earlier this year found that not only were dermatologists seeing an increase in mid-pandemic cosmetic consultations but that 86 percent of those doctors said patients referenced video conferencing as the reason they made the appointment.

Dermatologist Dr. Suchismita Paul says she’s noticed that trend in her own practice. “Normally, in regular life, people don’t see their expressions all the time — whether it’s things like smiling or frowning,” she explained. “But in Zoom, because you have that small window, you see your face when you’re frowning or smiling, and the lines are more prominent.”

Video chat also tends to distort the facial features, making the jaw and lower face look more prominent or heavy, or making what Dr. Paul calls “Resting Frown Face” — the intent look many of us take on when we’re thinking or listening carefully — seem like our face’s baseline expression. And, she points out, pandemic cosmetic surgery interest hasn’t just grown among remote office workers; she’s also seeing essential workers whose new normal is spending all day in a mask express more concern about the appearance of their upper faces: foreheads and eyes.

If baby Botox is the entryway to injectables, after more than a decade going under the needle, I’ve probably graduated to toddler Botox. And I’ve come to a place of comfort admitting this aspect of my cosmetic routine, at least among friends, acknowledging the privilege it reveals. The truth is that I am at an age, where, if I were to achieve something great (which appears increasingly unlikely the less-young I get) no one would remark on how impressive it was, considering my youth. I am also at an age where, if I were to die, people would shake their heads and sigh and agree that, yes, I was far too young to die.

But I still question my own motivations; am I failed feminist to care about abortion rights and dismantling structural misogyny and body neutrality when I do not feel neutral about my own body, but instead, prefer that portions of it are dominated by expensive toxins? If it is my body and my choice, but I choose to make my body bend itself to some ideal it cannot achieve on its own, am I making a real choice? I can’t decide.

Possibly, I tell myself, my personal aesthetics, which I’d like to think have been independently forged with a punk-rock disregard for sexist standards and over a lifetime, just happen to align with eons of beauty expectations imposed upon women. Because of this, I suggest to myself, to abandon my own preferences because of the patriarchy is what would really be submitting to the patriarchy.

I think the truth is we can never untangle what we want, as women, from what society tells us we should want. And while it’s worth interrogating — to get as close as possible to what we want instead of what we’re told we want — we’ll never get all the way there.

That conflict felt even more pronounced for me during a time when the concerns of the world felt so high stakes; what kind of woman did I really want to be? What kind of emphasis did I want to put on superficial things, like my personal appearance, when there was so much else that required my attention and care? On the other hand, after more than a year of facing death and dying on both a massive and, for many of us, intimate scale, who can blame us for seeking out whatever we can to feel vital, youthful, alive? In a moment when people are sharing more honestly and openly about the unruliness of bodies and our frustrations living inside of them — whether as seemingly insignificant as struggling with cystic mask-ne or as overwhelming as coping with the maddening symptoms of long COVID — maybe the era of keeping up appearances is over.

Dr. Kay Durairaj, who practices dermatology in Pasadena, California, seems to think so. “I really think social media has broken that [injectables] stigma,” she told me. “There isn’t much judgment anymore about people wanting to maintain their attractiveness. I think people understand you can be a woman of substance, of character, and still want to look good.”
On a night out for ramen with my boyfriend, the server — a young guy for whom aging is just a loose abstraction — looks at my ID in mock surprise after I order a beer. He actually calls me “babyface” and asks for my skincare regimen. I feel both infantilized and ancientized at the same time. If I could frown as hard as I think I am frowning, I would frown. But he leaves, and then I am no longer under his gaze. I look into the mirror across the way, steamed with noodle sweat, and see my face. I no longer look particularly young, and I don’t yet look particularly old. I look like myself; like someone I recognize. I smile at her, then turn away from my reflection, back toward the people in the restaurant, back toward the world.

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