I distinctly remember the first time I noticed a wrinkle on my forehead, mostly because it happened about two weeks ago. For some reason, while examining the mirror, the shallow-but-unmistakeable fault line came as a shock to me: a woman in her late ’20s who has never worn lotion a day in her life and has been trying to quit nicotine for the better half of a decade.
What bothered me most was that it bothered me at all. I don’t consider myself vain. For the first twelve years of my life, my mother had to bribe me to brush my own hair. But somehow this two-inch furrow above my eyebrow felt like a canary in a coal mine: It’s all downhill from here. And I wasn’t alone in my panic.
Between 2000 and 2016, the number of Botox treatments administered in the United States rose by a shocking 797 percent. Botox is the brand name for a neurotoxin called botulinum toxin, and when injected under the skin it works by blocking nerve signals to muscles, causing temporary paralysis. The way it “treats” aging is simple: you can’t get wrinkles if you can’t move your face. Since the COVID-19 pandemic, demand for the procedure has surged even further, with younger and younger patients going under the syringe to ward off evidence of life. Unsurprisingly, despite attempts by the plastic surgery industry to market “brotox” to dudes, over 93 percent of these patients are female.
How is it that we’ve managed to convince women, some of whom aren’t even old enough to order a drink at a bar, that they should fear the passage of time enough to spend thousands of dollars each year paralyzing their own muscles? I suppose, in a society that commonly discards women as soon as they’re un-fuckable—and in which being ugly is considered a moral failing—it’s actually not that hard of a sell. It’s even easier when injections are framed as self-care and critiques of the industry are brushed off with a patronizing “let people do what they want!” (A quick Google search will find dozens of blog posts, most of which are conveniently written by plastic surgeons, arguing that cosmetic surgery is simply a misunderstood method of boosting self esteem.)
But “treatments” like Botox are more insidious than they seem. In a social and political climate that increasingly requires our attention, our outrage, and our collective action towards issues that matter, any procedure that numbs our emotions is more than just a distraction. It’s a modern-day form of emotional lobotomy.
Humans are innately social animals, and evidence suggests that hundreds of thousands of years of evolution have allowed us to develop finely-tuned facial muscles, which play a significant part in nonverbal communication. Despite those AI-generated videos of dogs crying that your Grandma might share on Facebook, humans are the only animals on the planet that actually shed tears because of emotions. Scientists aren’t entirely sure why this is, except that communicating how we feel is important.
“From a kind of evolutionary perspective, it makes sense that lots of our signals become visual signals, because we are just quite visual animals,” biologist Marc Baker told Discover magazine. “Our kind of facial expressions far exceed almost every other animal, especially around the eyes.”
So what happens when those expressions are severed? It turns out that facial muscles do more than just convey emotions; they actually allow us to feel them in the first place.
In 2014, a team of neuroscientists analyzed the brain activity of ten women before and after receiving Botox. Before being injected, the women were shown a series of photos of strangers, each conveying angry, happy or surprised facial expressions. They were then asked to push a button, which categorized the emotions being shown as negative or positive. As expected, the brain's emotional center, called the amygdala, lit up more when people saw angry faces than happy ones—which is typical, because the brain reacts more strongly to perceived threats.
Subjects were then injected with Botox in the glabellar region of their foreheads (the area between the eyebrows, which humans use to frown). When the experiment was repeated several weeks later, MRI scans of the brain showed that the participant’s amygdala activity was significantly dampened while viewing faces that showed anger. The women could still recognize the emotion—the accuracy of their button pushing didn’t change much—but they no longer felt it as strongly. Nine months later, after the Botox had worn off, the process was repeated a third time. Without the toxin, the subjects’ amygdala activity returned to normal.
A 2009 study published in Cerebral Cortex found similar results using a slightly different method: instead of viewing emotional expressions, participants were asked to mimic them. Researchers scanned participants' brains before and after Botox injections while they imitated angry, sad, and happy faces. After the frown muscles were paralyzed, amygdala activity significantly decreased, especially during expressions of anger.
These studies, alongside a concurrent larger body of research, suggest that Botox doesn’t just mute outward expression. It dulls internal emotional responses too. Some women even report feeling happier post-Botox. In reality, the procedure is making them numb.
The scientific idea that our facial movements influence our internal emotions has existed for decades. An influential 1988 study showed that subjects who watched cartoons while holding a pen between their teeth—forcing their mouths into a smile-like position, like a dog carrying a bone—rated the cartoons significantly funnier than those who held the pen with their lips, which inhibited smiling. The participants didn’t realize they were being made to “smile,” but the physical act of doing so still altered their emotional response. This experiment, now a classic in psychology, helped support what’s known as the facial feedback hypothesis: the theory that our expressions not only reflect how we feel to others, but create those feelings in the first place.
Even if you’re not concerned about the mass-paralysis of women’s facial muscles, the more pressing question is why so many women feel compelled to go under the needle in the first place. The answer is simple, if grim: they know what aging does to their social standing. In nearly every aspect of life, from love to career, a wrinkle-free face may be a key building block to success.
Of course, most women who seek to climb the corporate ladder (or at the very least, be respected by their peers) would rather not be judged by their attractiveness. Unfortunately, they don’t have a choice. A 2022 study showed that as soon as women in executive positions approach middle age, they are perceived as “colder” and more difficult to work with—while their male counterparts retained the same level of “warmth” and “approachability.”
For women who hope to attract a male partner, the evidence is even more depressing. In his 2014 book Dataclysm: Who We Are, OkCupid co-founder Christian Rudder analyzed data from millions of users and found that women tend to be most attracted to men within three to six years of their own age (which makes sense, because people close in age often share similar life experiences and goals). Meanwhile men, regardless of their age, consistently rank women aged around 22 as the most attractive. Even into their 60s and 70s, men overwhelmingly prefer women barely out of college.
Rudder’s findings have been corroborated by multiple studies, including a large-scale 2018 analysis of online dating behavior that found men persistently seek younger women across all age groups.
The New York Times writes:
The researchers determined that while men’s sexual desirability peaks at age 50, women’s starts high at 18 and falls from there.
“The age gradient for women definitely surprised us — both in terms of the fact that it steadily declined from the time women were 18 to the time they were 65, and also how steep it was,” said Elizabeth Bruch, an associate professor of sociology at the University of Michigan and an author of the study.
Anyone who’s paid attention to more than three movies in their entire life can probably attest to this trend. In the public sphere, it seems that women’s lives begin as soon as they’re considered beautiful, and end once they’re not. A Geena Davis Institute study of 6,000 actors showed that at age 20, women held 80 percent of leading roles, but by age 30 it dropped to 40 percent. Past a mere 30 years old, women held only 20 percent of leading roles—while men’s share rose to 80.
The pattern is so common we barely notice it. In nearly every Hollywood blockbuster, male romantic leads are paired with women significantly younger, without so much as a raised eyebrow from the script. Take Johnny Depp and Denzel Washington, two of the industry’s most bankable stars: from 1990 to 2014, every single romantic film they headlined featured a love interest at least a decade younger. Not once was the age gap addressed. It was simply treated as normal.
So it tracks, then, for a woman who is just beginning to show signs of aging: why wouldn’t she consider a 30-minute appointment, a $600 fee, and a thin needle to the forehead, if it means buying herself a few more years of the world’s respect? And why wouldn’t younger women, seeing what lies ahead, fall for the same marketing?
If Botox was once a tool to erase the appearance of aging, the recently-coined “baby Botox” or “preventative botox” promises to stop aging before it can even start. The treatment refers to a smaller dosage of the injection given to women in their 20s, or even late teens, to prevent the formation of wrinkles altogether. With no clinical necessity and no medical emergency, it’s a business model built entirely on manufacturing a threat and then selling the solution. Equally concerning, since the concept is so new, there are no studies on the long-term consequences of freezing your facial muscles shortly after they stop developing. There’s only an expensive, ongoing subscription to a service that treats being a woman like a pre-existing condition.
Unsurprisingly, preying on half the population’s insecurities is a wildly profitable business strategy. According to SNS Insider, the global Botox market was worth $5.58 billion in 2023 and is projected to more than double in the next few years, reaching $13.74 billion by 2032. While that figure includes the use of Botox for medical purposes—such as the treatment of excessive sweating, migraines, and muscle spasms—the aesthetics segment led the BOTOX market in 2023 with a share of more than 60 percent of the overall market.
That’s a compound annual growth rate of over 10 percent, a staggering figure for a product that is overwhelmingly optional. But here's the thing about optional: it becomes a lot less of a choice when you can convince someone their social value depends on it.
While preaching to investors about future growth opportunities in the “non-invasive aesthetic procedures” market, SNS Insider says the quiet part out loud:
There you have it. After decades of selling injections to middle-aged women, the industry realized it had reached a saturation point. By coining terms like “Baby Botox,” they cracked open a previously untapped market: women who were too young to have wrinkles but old enough to be terrified of them. The earlier the insecurity starts, the longer the subscription lasts.
For some patients, it starts fresh out of high school. According to the American Society of Plastic Surgeons, between 2019 to 2022, neuromodulator injections rose a staggering 75 percent among ages 19 and younger. Some plastic surgeons have branded this recent surge the “the Zoom boom,” referring to the huge influx in demand for cosmetic procedures after the pandemic.
According to a 2023 study published in the National Library of Medicine, many patients now routinely “document their experiences with a plastic surgeon on Instagram, providing their results for other patients or prospective clients. These individuals use hashtags to connect their work to the specific provider, creating a stream of potential clients directed toward the surgical practice.”
What these surgical influencers rarely mention, however, are the potential long-term effects. It’s commonly known that not using your muscles can cause them to atrophy; just think of athletes who become paralyzed in their twenties and quickly lose mass in their legs from lack of use. It makes sense, then, that paralyzing your forehead muscles for decades on end could have similarly damaging effects.
Dr. Lynn Damitz, chief of the division of plastic surgery at University of North Carolina Hospitals, spoke to the UNC Media Hub about these potential risks:
I think when it comes to people doing it for preventative purposes, there is a concern that by atrophying the muscle or injecting the muscle to such a degree at such a young age[…] is that going to lead to other potential issues over time, whether aesthetic or functional.
If you’ve limited that muscle’s ability to ever contract, is it going to atrophy? Get smaller? Not be as functional?
I suppose, like many harmful trends, we won’t know until it’s too late.
Maybe one day we will look back and laugh at the era when young women supported a multi-billion dollar industry by voluntarily paralyzing their own faces. Like corsets or tapeworm diets, it will be treated as an absurd historical footnote: that time when beauty meant dulling your emotions and pretending not to age. More likely though, this is simply another chapter in a very long history book filled with selling women discomfort.
The good news is, we don’t have to buy it. The only way to interrupt this cycle is by refusing to treat insecurity as a necessary expense. And the most radical thing we can do might just be to age in public.
