The Effects of BOTOX Injections on Emotional Experience
Open accessAbstract
Although it was proposed over a century ago that feedback from facial expressions influence emotional experience, tests of this hypothesis have been equivocal. Here we directly tested this facial feedback hypothesis (FFH) by comparing the impact on self-reported emotional experience of BOTOX injections (which paralyze muscles of facial expression) and a control Restylane injection (which is a cosmetic filler that does not affect facial muscles). When examined alone, BOTOX participants showed no pre- to posttreatment changes in emotional responses to our most positive and negative video clips. Between-groups comparisons, however, showed that relative to controls, BOTOX participants exhibited an overall significant decrease in the strength of emotional experience. This result was attributable to (a) a pre- versus postdecrease in responses to mildly positive clips in the BOTOX group and (b) an unexpected increase in responses to negative clips in the Restylane control group. These data suggest that feedback from facial expressions is not necessary for emotional experience, but may influence emotional experience in some circumstances. These findings point to specific directions for future work clarifying the expression-experience relationship.
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Inhibition of facial muscles involved in emotional expression through Botox injection weakens the corresponding emotional experience and reduces activity of the amygdala and brainstem.
“On the one hand, studies have shown that the inhibition of those facial muscles involved in emotional expression through Botox injection weakens the corresponding emotional experience [69] and reduces the activity of the amygdala and brainstem [70].”
From Interoceptive Ability and Emotion Regulation in Mind–Body Interventions: An Integrative Review (2024) · cites this paper as [69]
The Abstract and Discussion report weaker emotional experience after Botox relative to controls, but not a general weakening of the emotions corresponding to the paralyzed muscles. Botox participants showed a decrease for mildly positive clips, while the overall between-group effect also reflected an unexpected increase in the control group; responses to the most positive and negative clips did not decrease. The amygdala and brainstem claim is assigned to citation [70], not this source. (LLM, conf=0.88)
Experimental — accuracy not yet measuredEnactment of a facial expression or a posture facilitates the corresponding emotional experience and influences the way emotional information is processed.
“On the other, there is compelling evidence that the enactment of a facial expression or a posture facilitates the corresponding emotional experience and influences the way in which the emotional information is processed [67,69,71,72].”
From Interoceptive Ability and Emotion Regulation in Mind–Body Interventions: An Integrative Review (2024) · cites this paper as [69]
The Abstract says that posing a facial expression has consistently been found to increase the intensity of emotional experience. The Conclusion says body-state information can affect judgment and experience, but the paper does not establish the claim about enacting a posture or specifically show that enactment changes how emotional information is processed. The paper also limits facial feedback's contribution to some circumstances. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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- Authors
- Davis, J. I., Senghas, A., Brandt, F., & Ochsner, K. N.
- Affiliations
- Columbia University (US)
- Venue
- Emotion
- Published
- 2010
- Volume
- 10
- Issue
- 3
- Pages
- 433-440
- ISSN
- 1528-3542 (ISSN-L)
- 1931-1516
- PMC
- PMC2880828
- OpenAlex
- W1994137059
- Cited by
- 258
- References
- 29
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 10 · 2023: 12 · 2022: 10 · 2021: 11 · 2020: 65 · 2019: 28 · 2018: 12 · 2017: 7 · 2016: 15 · 2015: 15 · 2014: 20 · 2013: 16 · 2012: 14
- FWCI
- 8.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Emotion (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (MH071637)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Emotion and Mood Recognition
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- facial feedback hypothesis, onabotulinumtoxinA, Restylane, facial expressions, emotional experience, emotional intensity, facial paralysis
- MeSH terms
- Adult, Cosmetic Techniques, Emotions, Facial Expression, Facial Muscles, Female, Humans, Middle Aged, Botulinum Toxins, Type A
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