Comment by mdip | Hacker News Reader

Comment by mdip | Hacker News Reader

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I saw the title and that was the first thing I thought of.

I was sincerely hoping that "magic drug" wasn't referring to its use in cosmetic surgery[0].

As I'm not a member of anything medical-field related I was unaware that it had been used to treat "blepharospasm"[1]. Having gone through that to the point of actually seeking treatment, I'm disappointed my doctor wasn't aware of that option. At the point -- two days with no sleep -- I would have raided the drawers and given myself a shot.

But, really, Botox is what most people think of when thinking "magic drug." I'm not sure that's the word I'd use.

I'm a guy in my 40s with a pretty typical subset of people categorized as "I used to know them in High School". Literally in the period of 4 years about 25% of the women in my friends list were very clearly talked into getting Botox. One woman must be involved in some multi-level marketing scam related to Botox because she's frequently posting pictures of her face "post treatment" (and, I'm sorry, it's grizzly)

I have to believe that some people have good results. But, no joke, I can pick out at least 10 women who have what I call "Botox Face". You notice it first in the lips -- "permanent semi-duck-face". Then they start talking -- large portions of their face don't move as expected. I had a co-worker who had it done, missed a few days of work, and when she returned I had assumed she suffered a stroke (thank God I didn't say anything). I had known she had Botox before (she had the lips already) so this was a second course of treatment.

Despite how this sounds, this wasn't intended as an attack on folks who use Botox. I'm truly curious -- it seems like a lot of people have this done and the results are much worse than before for many of them. How many is anyone's guess ... in theory, it would be impossible to tell the difference between good Botox and "natural" but I can't think of another form of cosmetic surgery that has worse results. But considering how many people have bad results, why do so many people continue to get it done (including folks who previously had bad results!)

[0] Ok, maybe just a little, because it's an "easy target".

[1] Such a fun word -- one that people know if they've ever had their eye twitch consistently for a month (try sleeping that way).

> You notice it first in the lips -- "permanent semi-duck-face"

This is filler. Botox doesn't plump out features. (I've never had botox, but I have friends who have. The difference between discount and top-tier Manhattan plastic surgeon administration is noticeable. Or, I suppose, not.)

You're right -- I mix the two up because I've rarely seen someone get injections that hasn't done the Botox thing. I assume it's the Botox that makes their lips move ... strangely?

Fun fact: cosmetic Botox led directly to the discovery that it could be used to treat chronic migraine — some people who received it for cosmetic reasons noticed that it improved their headache symptoms and reported this to their doctors.

I was in Botox for migraine in the early days. Had more than one conversation with someone who was clearly mistaken that I’d said I was taking Botox for cosmetic purposes very probably because they had. Made for a funny conversation, but not bad. And others asking whether it’s like cosmetic Botox.

I’ll be forever grateful to the people who noted it helped their headaches!! I don’t want to imagine how different my life would be without it.

Misunderstanding of Botox procedure aside ("duck" lips being filler rather than Botox), is this just not a restatement of the toupee fallacy?

Probably. IIRC the price of Botox injections has come down a lot in recent years, and it's a relatively safe outpatient procedure, so if social media trends are anything to go by I'd assume quite a few people are getting it.

Any good cosmetic work should be almost invisible to someone who isn't looking at a before-and-after photo. I recently got some work done (long story, but one of the best decisions I've ever made) and my doctor said he strives to do work that's so discreet no one will notice and so gratifying that you'll tell everyone anyway.

"Having gone through that to the point of actually seeking treatment, I'm disappointed my doctor wasn't aware of that option."

This is really surprising. If you Google 'blepharospasm treatment' and read a few articles, it's impossible not to come across Botox. And this isn't even recent... About 20 years ago, I did a project related to commercializing an innovative treatment of blepharospasm, and I recall contrasting this new treatment against the alternatives available at the time. Botox was one of them.

The biggest problem was being taken seriously. Everyone gets an eye-twitch from time-to-time. I made a special appointment with my PCP and was told "get more sleep", reduce stress and eat more things containing potassium... I have since found a new doctor. :)

This was the early 00's but considering your project 20 years ago, that lands in at about the right time-frame.

I think people see the pictures and it looks like it might be an improvement but it's the motion of expressions that really makes it look weird/uncanny. A human face is always moving and it reads very wrong to see it move wrong.

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