The Discovery of Botox
“There’s no putting the genie back in the bottle,” says Dr. Alastair Carruthers, named by The Observer as one of the “50 men who really understand women.” The genie is Botox, whose wrinkle-busting effects he and his wife, Jean, discovered in 1987. Since then, Botox has become a billion-dollar industry, North America’s No. 1 cosmetic procedure and the inspiration behind a crowded new generation of fillers, intense-pulsed-light and radio-frequency therapies, and other age-fighting products. This husband-and-wife team has played a major role in reshaping our notion of beauty.
Despite all this, the Botox founding legends are low-key. In 1987, Alastair divided his Vancouver dermatology practice between surgery for skin cancer and cosmetic procedures. He shared his office with Jean, an eye doctor who treated pediatric disorders as well as adult conditions such as blepharospasm. An uncontrollable blinking and spasming of the eye and surrounding area, blepharospasm was treated with a dilute solution of botulinum toxin, which, injected into the skin, temporarily paralyzes the spasming muscles. One day, by Jean’s account, one of her blepharospasm patients became irate that her forehead was not being injected. “But your forehead isn’t spasming,” Jean responded, and asked why she cared. “Because when you inject my forehead,” the patient said, “my wrinkles go away.”
At dinner that night, Jean mentioned to Alastair the woman’s reaction. He and his dermatology patients had been frustrated in their attempts to erase vertical frown lines between the eyebrows, known to doctors as “glabellar lines.” The fillers available at the time didn’t last long and could be painful. The next day, Jean talked their receptionist, Cathy Bickerton, into being the first guinea pig for the cosmetic use of botulinum toxin. Once Alastair saw the results, he needed no persuasion. “I had the patients,” he says, summing up what would become one of the most successful symbioses in late-20th-century cosmetic medicine, “and Jean had the toxin.”
Both expected the world to embrace their discovery. Instead, says Jean, the typical reaction was, “You want to inject what into my wrinkles?” At this point, Jean injected herself, whence her famous boast that she hasn’t frowned since 1987.
When they presented their results at the American Society for Dermatologic Surgery meeting in Orlando in 1991, she remembers, medical friends told them it was “a crazy idea that’s going nowhere.” But the Carrutherses continued conducting clinical trials— although it was difficult to find willing patients—and presenting their findings at dermatology meetings, watching their audiences slowly grow.
The snowball effect started in 1993. “Botox,” as the treatment was now called, began to sweep the world. Jean qualified as a cosmetic surgeon; she now does mostly head and neck procedures, and treats very few ophthalmological patients. Her husband stopped doing cancer surgery and now does full-body liposuction as well as head and neck cosmetic procedures.