Botox and the poker face

June 9, 2011

Injecting Botox is a science, but it is also an art.
Injecting Botox is a science, but it is also an art.

When you see a child crying, what do you do? You wrinkle your brow, turn down the corners of your mouth and make reassuring sounds. That way the child can see that you get what he or she’s feeling. Same deal when your husband comes home with a leg in a cast or your best friend announces a divorce.

“We read other people’s emotions in part by mimicking their facial expressions.” So says David R. Neal, PhD, psychology professor at the University of Southern California, reporting to Web MD on April 25th. He says that facial mimicry is like a sixth sense, and if you can’t move your face, you lose this ability. “If you have a poker face because your muscles are paralyzed, you can’t read the emotions of others as well.” In other words, your ability to respond to another human with appropriate facial expressions lets you know how they feel.

Neal’s study compared people who had Botox injections with people who had Restylane injections. The Botox-injected people were significantly less accurate at reading others’ emotions than those who were injected with Restylane.

In reviewing the study, a New York plastic surgeon thinks that Neal presents an exaggerated view of what Botox does. “You can have normal facial expressions with Botox unless you blast a face with so much that you can’t move your forehead.” But that same surgeon admits that most people who get Botox injections are overtreated, which could be a reason for this miscommunication.

Injecting Botox is a science, but it is also an art. Your results will vary greatly, depending on your injector, and if you are careless in choosing an injector you may not only be temporarily stuck with a frozen forehead but also with droopy eyelids or overly-elevated eyebrows.

According to the American Society for Aesthetic Plastic Surgery, in 2010, Botox and Dysport injections were the number one minimally-invasive cosmetic procedure performed in the United States.


The mission of the American Society for Aesthetic Plastic Surgery (ASAPS) includes medical education, public education and patient advocacy. Plastic Surgery News Briefs are summaries of current stories found through various news and magazine outlets that relate to or mention plastic surgery and cosmetic procedures. The views expressed in these news articles do not necessarily reflect the opinions of ASAPS, but are merely published as an educational service to our members and the general public. For additional information on these subjects and other plastic surgery related topics, please go to www.surgery.org

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The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body.  ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.

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