Women are getting Botox to fix 'resting b---h face,' and a psychologist says the trend is troubling

Julia Naftulin

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  • Women have been increasingly been seeking Botox treatments for something other than wrinkles: They want to freeze their faces into a more pleasant expression so they don't appear to look mean or unapproachable.
  • A board-certified plastic surgeon based in New York City said he gets multiple requests for this procedure every week.
  • The idea that women need Botox to look nicer and more approachable is sexist and only made worse because of social media, a psychologist told Insider. It also won't solve women's underlying body image issues. 
  • Visit Insider's homepage for more.

If you want to hide your emotions or lack thereof, Botox could help. Recently, dermatologists say women have been seeking the treatments for something other than wrinkles: They want to freeze their faces into a more pleasant expression so they don't appear to look mean or unapproachable, an expression widely known as "resting b---h face."

Botox refers to botulinum toxin, a neurotoxin that works by paralyzing parts of the body to prevent wrinkles and fine lines from forming.

"This is actually a common request from patients — I get several each week," Dr. David Shafer, a double board-certified plastic surgeon in New York City told the New York Post about the popularity of Botox for preventing resting b---h face.

The phenomenon has been growing over the years, with a 2018 episode of Insider's "Household Name" podcast tracing the story back to "the discovery that the deadliest toxin on earth could make a face look less 'troubled.'" 

Although the health risks associated with Botox, like muscle weakness and difficulty breathing, are rare, the idea that women need a special treatment to make them appear kinder is a troubling body image trend, psychologist and Rutgers University professor Charlotte H. Markey told Insider.

"Self-acceptance is not just about how we look," Markey wrote in an email to Insider. "Data suggests that cosmetic procedures don't have a lasting effect on people's positive body images nor their general well-being."

Cosmetic procedures are generally safe, but they won't necessarily fix self-esteem problems

Although Botox comes with a few health risks — it can lead to light bruising, flu-like symptoms, drooling, and droopy eyes post-injection — the procedure is considered safe overall and isn't permanent, making it an attractive option for someone who wants to alter their appearance in a minimally invasive and quick way, dermatologist Dr. Joshua Zeichner told Insider. According to the Mayo Clinic, results from Botox can last three or more months and Zeichner said it only takes five minutes to perform the treatment.

But the concern with Botox for an unhappy-looking face isn't its safety, it's that people tend to get the procedures because they feel a need to fix a perceived problem with themselves, Markey said. And Botox or other appearance-altering treatments can't offer a permanent fix for self-esteem issues. 

A small 2008 survey-based study from researchers in Norway found that people had improved body images after undergoing a cosmetic procedure, but the researchers also found that people who had psychological problems before surgery still had those problems following their cosmetic changes.

Those psychological problems include anxiety and depression related to one's appearance, according to a 2018 editorial on the link between body dysmorphia and cosmetic procedures published in the International Journal of Women's Dermatology.

Read more: Several woman say botched lip injections at an Arizona clinic led to oozing, swelling, and pain

Maintaining a positive body image comes down to certain behaviors and beliefs, not cosmetic procedures. Markey said she's found women who do have positive body images seem to share practices and beliefs like self-care, the belief there's more to life than one's looks, and participation in volunteer work.

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The Botox for resting b---- face trend is rooted in sexist beliefs

Markey also said the idea that women need Botox to look nicer and more approachable is quite sexist and only made worse by social media.

"This is mostly about people making money. Something comes up in popular culture and a 'solution' is created," like Botox that makes you look pleasant and happy all of the time, Markey said. "Social media is pervasive and facilitated the spread of beauty trends and beauty 'fixes.'"

In fact, the pervasiveness of social media-driven beauty fads has become so widespread, Instagram recently instated a policy that blocks people who are younger the 18 years old from seeing certain posts about cosmetic procedures and weight loss products.

Additionally, these face-altering injections seem to be targeted mainly towards women, which demonstrates "not-so-subtle sexism," according to Markey. Women are well aware of the societal pressure to be liked by virtually everyone, while men don't have that problem. When men act assertive they're often praised, but women tend to be looked down upon for exhibiting the same behavior, especially if it's not tempered with a smile.  

"There is nothing wrong with being nice and approachable," Markey said. "But we don't have to change our appearances to reach this goal."

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