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young attractive woman looks into a mirror (Marco Baass/Getty Images/iStockphoto)
young attractive woman looks into a mirror (Marco Baass/Getty Images/iStockphoto)

She thinks botox is the answer to her problems. How do I stop her? Add to ...

The Question: My friend is convinced she has wrinkles and needs to get botox. She has absolutely no wrinkles that I can see (in fact, her skin is wonderful). I am concerned about her warped perception of her appearance. Why can’t she be happy with how she naturally looks?

The Answer: A female’s relationship with her appearance is one of the most complicated relationships she will encounter in her lifetime. The relationship is mitigated by a number of factors, that includes a strong sense of self, confidence in other traits and attributes she possesses, and her overall sense of happiness.

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Our modern day society, however, is wreaking havoc on the self-image of even the most secure women, and I am seeing in increasing number of particularly younger, objectively attractive women in my practice who are consumed with undergoing procedures to further enhance how they look.

I think this is an artifact of a number of factors.

We live in the age of a technological revolution where we are literally bombarded with myriad images, on every medium and form, that set expectations for what society’s ostensible “standards” are for beauty. One would be hard pressed to find a television show or film without a star that has either privately or – as is the current trend – publicly pronounced the cosmetic surgeries she has had. Gone is the shame and stigma with undergoing enhancement procedures. And, gone are the days where cosmetic surgeries were only for the very rich and famous. The last decade has witnessed an explosion of the range of available cosmetic procedures and clinics, and the drastic drop in costs has made many of these services accessible to the every-woman.

Virtually all of us engage in some element of appearance enhancement – ranging from the clothes we wear, the grooming practices we engage in, and the makeup we put on. A decision to engage in something more significant (and arguably not benign in terms of long term health impacts) is a very personal decision.

As a friend, your job is to support and not judge your friend for the very personal decision she is making; however, as a friend, it is also your job to (respectfully and kindly) express the concern you have to her. Start a dialogue with her about her reasoning for wanting to get botox. Most importantly, listen to her reasons, as that may give you an indication whether her decision is a temporary knee-jerk reaction to fleeting insecurity or unhappiness, or if it is a well-thought out, considered decision to engage in a procedure, fully understanding the potential risks. If the former, try to listen to support your friend as best as you can and ask her what you can do to help. Encourage her to defer the decision until she is in a better place emotionally. If the latter, focus on keeping your opinions to yourself, and maintaining the friendship.

Dr. Joti Samra, R.Psych., is a clinical psychologist and organizational & media consultant. She is the host of OWN: Oprah Winfrey Network’s Million Dollar Neighbourhood and is the psychological consultant to CITY-TV’s The Bachelor Canada. Her website is www.drjotisamra.comand she can be followed @drjotisamra .

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The content provided in The Globe and Mail’s Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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