What exactly is ‘cosmetic infidelity’? Here’s why keeping your Botox a secret can mess with your mental health

August 10, 2022

If we had a dollar for every time a celebrity credited their youthful glow to drinking a lot of water, we’d be able to afford a lifetime supply of filler. Yes, staying hydrated is proven to energize your muscles, invigorate your skin and aid in digestion, but unfortunately it can’t do all the heavy lifting for a plump, wrinkle-free face. 

The lowdown on aesthetic procedures

What *is* proven to yield those tangible, skin-smoothing benefits are skin treatments like neurotoxin injections (think Botox, Jeuveau, and Dysport) and dermal fillers (Restylane and Juvéderm are a few of the big names). According to the 2021 American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) member survey, these types of non-surgical cosmetic treatments are up drastically. Neurotoxin treatments were up 40 percent in 2021, and dermal filler treatments were up 42 percent. In fact, The Aesthetic Society found that Americans spent more than $14.6 billion dollars on aesthetic procedures in 2021.  

“The use of video for business, social media, and self-promotion is now so ingrained in society that it provides an easy and ever-present lens for self-scrutiny,” says AAFPRS President Corey S. Maas, MD, of the survey results. “We’ve slowly moved from static image filters to ‘Zoom dysmorphia’ being the major patient motivator as the pressures of a virtual lifestyle continue to impact the way we view ourselves and the way we present to peers.”  

The stigma behind the secrecy

While the expectation placed on people—particularly women—to maintain a youthful look without any cosmetic help is prevalent in our society, there’s still a stigma associated with Botox and fillers. Ironically, the stigma is perpetuated because people are hiding the fact they’ve had these treatments.

A quick Google search for ‘how to hide plastic surgery recovery’ yields more than 7.5 million results, and providers have infinite stories of patients hiding their cosmetic treatments from family and friends for fear of being judged or ridiculed. Dermatologist Rachel Nazarian, MD spoke to Town & Country about treating patients while their partners are away on a work trip so they can keep the recovery private. “I’ve had women use a combination of credit cards and cash to pay for treatments or ask the office to split the payments and charge it all separately over a week or two,” says dermatologist Sejal Shah, MD, in the same article.  

Why people commit ‘cosmetic infidelity’

So, why are more people not admitting that they’ve had a little help beyond ordinary topicals? Money is one of the factors that could lead a patient from hiding procedures from a partner, family, or friends, but other, more emotional factors like insecurity, shame or fear of looking vain can also play a role. This type of secret-keeping in relationships is so commonplace, it’s even earned a name: cosmetic infidelity. And while this breach of trust might not seem as extreme as its original namesake, it can still have an effect on both relationships and your mental health. 

Orange County, California-based psychiatrist Leela Magavi, MD, told HelloGiggles that she defines hiding cosmetic work from a partner as more of an omission than a straightforward lie, and that not all omissions are necessarily bad in a relationship. “If a man or woman were to steal in order to attain the funds for surgery, I would perceive this as deceptive and inappropriate,” she says. Dr. Magavi also warns that hiding cosmetic treatments, like Botox or fillers, from a partner can lead to conflict and discord. When the omission is more emotionally driven, she encourages her patients to confide in their significant others to help eliminate those insecurities entirely.  

The surprising mental and physical health downside

Regardless of the reasons for keeping cosmetic treatments on the down low, the secrets you keep can physically make you sick. Experts say that keeping a secret can significantly boost your stress hormone, triggering a fight or flight response and feelings of anxiety. Plus, every subsequent time you think about that secret, it re-boosts your stress hormones, which can impact your memories, your blood pressure, your gastrointestinal tract and even your metabolism long term. 

When in doubt, honesty is always the best policy. There’s nothing wrong with wanting to look your best, but keeping your dermal treatments “hush-hush” not only has potential mental or physical repercussions, but also causes society to keep up the charade that we aren’t aging. Try to shift your inner monologue and remember that aging is a privilege as well as an unavoidable part of living. And if you need even more convincing, regardless of what you hear, just remember that there were more than 5.5 million neurotoxin or dermal filler treatments last year. And if the trend continues, it’ll only go up from there. Wouldn’t it be refreshing if we were all acknowledging that?

The views expressed in this article do not necessarily represent the views of Murad, and are for informational purposes only, even if the advice of physicians and medical practitioners are included. This article is not a substitute for professional medical advice, diagnosis or treatment, and should not looked be considered specific medical advice.  

References for this information: 
American Academy of Facial Plastic and Reconstructive Surgery
The Aesthetic Society, Procedural Statistics 2020-2021
The Guardian, September 2021
Town & Country, February 2019
Scientific American, 2019
Forbes, 2013

About the Author

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Maddie Aberman has been covering beauty and wellness for more than eight years. Her work has appeared in Allure, Cosmopolitan, Popsugar, Women's Health, IPSY, Good Housekeeping, and Seventeen, among other publications.