Back on November 19, Democrats proposed enacting a five percent tax on elective cosmetic procedures as a way to raise six billion dollars to pay for the nation’s healthcare system overhaul. Immediately dubbed the “Botax” by pundits, the idea drew instant fire from cosmetic surgeons, dermatologists and women who enjoy free access to the cosmetic procedures that enhance their appearances and often their self-esteem.
One of our areas of greatest interest and academic study is the intersection of beauty and the brain. A great deal of research has shown that having cosmetic improvements improves one’s mood, self-image and quality of life. It’s not known yet whether that improvement is purely due to greater confidence and pleasure in seeing oneself looking younger and more attractive, or whether there is a mechanism that affects brain function (akin to reports from women with Botox injections that they have a harder time crying). What remains clear is that improvements in beauty tend to correlate with improvements in mental state. So what does lawmakers’ willingness to tax breast implants and tummy tucks say about our attitude toward beauty?
Let’s use other popular taxes as a parallel. The most common tax on elective “lifestyle” choices is the “sin tax” placed on cigarettes and hard liquor in most states. These taxes are levied in part because smoking and drinking are perceived as potentially harmful activities that are basically recreational luxuries; the taxes are, in part, a way of the government saying, “If you’re going to do these things and cause potential problems such as drunk driving and lung cancer, we’re going to tax you for the privilege.” So, by this logic, is Congress saying that cosmetic procedures are equally frivolous and harmful choices made primarily by women (who, by the way, make up only 91 of the 535 seats in the legislative branch)?
That might be overstating, but it’s clear that the message being sent is that Botox and the many other procedures upon which women (86 percent of patients are women) spend billions per year are a somewhat frivolous luxury primarily enjoyed by rich people with too much time on their hands. This could not be more wrong. First of all, according to the American Society of Plastic Surgeons, 60 percent of women who get work done have household incomes between $30,000 and $90,000 a year. These are not the idle rich, and a five percent levy would have a real impact on their lives.
More importantly, while a small minority of cosmetic procedures may be playthings for desperate cougars trying to defy time, most women are simply trying to look and feel their best, correct what they see as defects, and enhance the quality of their lives. Beauty matters; it shapes our self-image, our relationships and our career opportunities. It is not an idle luxury nor a socially costly habit like smoking two packs a day, and it should not be forced by a tax into the “sin” category. Beauty, and the doctors and patients who pursue it, should be given their proper respect.
Imagine the stereotypical Botox patient. Go ahead. Are you seeing someone from “Real Housewives of Orange County,” a woman whose face is immobile after countless invasive plastic surgeries and who is so obsessed with defying the aging process that she’ll mutilate herself and inject her body with dangerous toxins to avoid a furrowed brow?
That’s the stereotype all right. But it’s false. It’s a phantasm born of a dozen bad reality TV shows. Sure, there might be some women for whom Botox is one part of a shallow, self-absorbed trek into deep denial, but the huge majority of women who get the procedure are normal, healthy people who just want to look better and feel better. Yes, we said feel better. In The Beauty Prescription, we talked a little about research that showed that having Botox treatments actually made women feel more positive. Now there’s more evidence that the phenomenon is real .
Research results published in the March issue of the Journal of Cosmetic Dermatology suggested that based on a controlled study, people who received injections of Botulinum Toxin A (Botox is the brand name) to paralyze the muscles in their brows and make them incapable of frowning actually showed fewer negative emotions and experienced lower levels of depression and anxiety. Twenty-five volunteers participated, and while 12 recieved Botox, the control group got facial peels and other therapies for “frown lines.” After two weeks, all the patients filled out surveys on their emotional states. The patients who got Botox scored much lower for depression, irritability and anxiety.
What we find very interesting is that the Botox patients said their improved mood didn’t stem from feeling more attractive after the treatments. We agree with the researchers who surmised that the effect probably came from a kind of “feedback loop” (our Beauty-Brain Loop in action) in which facial expressions that reinforce positive emotions stimulate more of the same in a person, while expressions such as frowning stimulate anger, fear, irritation and stress. Essentially, when you frown, you might be cueing yourself to feel like there’s something to frown about, which makes you frown more. As goes thy face, so goes thy mood.
This is a small sample size and there’s more work to be done, but we find this research incredibly promising for promoting the idea of holistic beauty. In a holistic system controlled by the Beauty-Brain Loop, how you react to your environment stimulates your inner beauty, which affects how you look physically. Your appearance sparks a reaction from the people around you, who are also part of your environment, and that reaction feeds back to you. Simply put, think beautiful and smile, and you become beautiful. The evidence is piling up that this is so, and it offers wonderful possibilities for women and men to take control of their own internal and external beauty simply by making new, conscious choices for how to view life, people, and the events of the day. Imagine if you could be more beautiful on your own, without injections, by choosing to smile instead of frown.
Either way, Botox or no, it’s exciting. We’ll keep you posted on more research of this kind as it comes along.
Well, so much for the idea that doctors are any more “recession-proof” than anyone else.
We’ve heard that statement a lot recently. Along with morticians, peace officers and firefighters, physicians are supposed to have some sort of “Get Out of Recession Free” card when it comes to an economic downturn, presumably because people still get sick, need therapy and so on. But we’ve already seen evidence that it’s a false idea, as hospitals are losing money and some are threatened with closure. So it should come as no surprise that cosmetic surgeons are seeing a downturn in their business.
After all, people are already delaying treatment and skipping medication for serious health problems because they lack health insurance or can’t afford the co-pays, so it’s hardly a shock that more are passing altogether on elective procedures. That’s what the Chicago-based American Academy of Cosmetic Surgery says is happening. In a survey of 242 members released on January 14, the Academy revealed that nearly 80% of cosmetic surgery practices had reported a drop in business, with the average being a whopping 50% reduction in the third quarter of 2008.
The Economic Impact Survey also showed that more and more patients are choosing cheaper, less-invasive procedures than when the economy was strong and they felt flush. In fact, since all cosmetic surgeons have to train in another specialty before going into cosmetic medicine, the survey found that about one-third are going back to former areas of training such as general surgery, ear/nose/throat or obstetrics & gynecology in order to make a living during these tough times. Those who don’t want to go that route are shoring up their practices with cosmetic procedures that are more commonly done by a dermatologist: fillers, Botox, liposuction, chemical peels and microdermabrasion.
In fact, these non-invasive or minimally-invasive options are just about the only cosmetic procedures that are becoming more common, with reports coming in that the rates of Botox injections are actually up around the country. What does this say about us as a people, especially since just a few posts ago we reported that people are still spending on beauty products such as cosmetics and skin care products? Well, it’s obvious that there’s an inverse relationship between the cost of the procedure and the willingness to have it done. A $30 jar of moisturizer is fine, but $2,000 for an eyelid lift…that’s going to have to wait until the stock market goes back up.
Clearly, we still are willing to spend money and invest in our looks. It remains a priority for the same reason we discussed in that last post: because it gives us control over some aspect of things when it seems like everything else is spinning so out of control. But we are becoming more luxury-conscious, and there’s a self-imposed “frugality line” that we won’t cross. Hard economic times cause most of us to “reboot” our priorities and take a hard look at what is worth paying for and what must be put off, and the answer is different for everyone. For some women, getting a regular microdermabrasion treatment in her dermatologist’s office will remain a priority even if she can’t afford a new pair of shoes; for another, she’ll make her own facial scrub with kitchen ingredients or do without.
Our theory is, the more your outer beauty is a critical aspect of your self-image and the more your self-esteem depends on it, the more willing you will be to spend money you might not have on cosmetic treatments. The more comfortable you are with yourself on the inside, the more likely you’ll probably be to go back to basics until things turn around. Inner beauty, thank goodness, tends to be free. As the economic situation plays out, we’ll see if our theory is correct.