Mrs and Mr Botox

Interview: Bernadette Calonego

Twenty years ago, Jean Carruthers (62), an ophthalmologist in Vancouver, Canada, described for the first time, together with her husband, the dermatologist Alastair Carruthers (66), the fact that Botox could make wrinkles disappear. Their discovery changed the world of cos-metic treatments. It became a billion-dollar-business – but not for the Carruthers. A fact that does not seem to bother them at all.
Interview: Bernadette Calonego (published in SZ-Magazin, Germany, May 6, 2011)
SZ-Magazin: You had to get over at least one big disappointment in your life. But looking at you, I cannot see it. Is it because you both have been treated with Botox?

Jean Carruthers: I had a facelift eleven years ago and I treat my wrinkles with Botox, I am very open about it. As cosmetic physicians, we have to look good because we use the product that we sell. However, I don`t think that we do not show the joys and sorrows life has dealt to us. Botox should not reduce an individual’s ability to express themself!

Alastair Carruthers: What sort of disappointments are you talking about?

SZ-Magazin: In 1990, your wife and you have described scientifically the effect of Botox on wrinkles for the first time. But you did not have this treatment patented.

Alastair Carruthers: Yes, maybe we would do things a bit differently today.

SZ-Magazin: A bit differently? You have given away billions so to speak!

Jean Carruthers: A patent lawyer in Toronto told me at the time that the cosmetic treatment with Botox did not justify a patent. Today I would ask a second and third opinion.

SZ-Magazin: This was obviously a huge misjudgement by this lawyer. Do you bear a grudge against him?

Jean Carruthers: No, we have enjoyed our work so much, with or without a patent.

SZ-Magazin: Could you have participated somehow in the production of Botox at the Com-pany Allergan?

Jean Carruthers: Not without relinquishing our academic independence which we would not want at all.

SZ-Magazin: It is hard to believe that you take it so composedly.

Jean Carruthers: Why should we get stuck in the past? We have done a lot of other things in the meantime. We have a busy, busy practice. We have published research papers. We also want to have a normal life.

SZ-Magazin: Dr. Carruthers, for a 62-year-old woman with Botox treatment, you look aston-ishingly natural.

Jean Carruthers: Thank you for the compliment.

SZ-Magazin: The famous actress Katherine Hepburn once called you, Mr. Carruthers, “very handsome”. Why then do you need Botox?

Alistair Carruthers: I had only my vertical frown lines done because, with a man, they can perceived as threatening. The horizontal lines however suggest curiosity and involvement.
I had also my underarms injected with Botox in order to prevent sweating because we spend a lot of time lecturing. It was uncomfortable but it is well worth it!

SZ-Magazin: Botox is the deadliest toxin known today, isn’t it?

Alastair Carruthers: Correct, but Botox is a fragment of a protein and you get one to three billionths of a gram with a cosmetic treatment. Your body has no problem dealing with it.

SZ-Magazin: Some people reportedly have become addicted to Botox.

Alastair Carruthers: It is addictive in the same way brushing your teeth is addictive because it produces the desired result. It is not chemically addictive.

SZ-Magazin: How is it with side effects? Some physicians link the use of Botox to memory problems.

Jean Carruthers: There isn`t any scientifically supported information pointing to memory loss. But there is good research linking Botox with mood elevation, especially for people who are depressed.

SZ-Magazin: How did you discover the effect of Botox on wrinkles 24 years ago?

Jean Carruthers: It was quite a coincidence, actually. As with many other ophthalmologists, I have treated involuntary spasming of the eyelids or uncontrollable blinking with this neuro-modulator. A female blepharospasm patient of mine told me that when I injected Botox into her forehead, it made her wrinkles disappear.

Alastair Carruthers: The following day, it was very hectic in the practice, and at 2 o`clock in the afternoon, the receptionist looked rather cranky. Jean talked to her and bang-bang! After-wards, the receptionist looked so relaxed!

SZ-Magazin: What do you mean by bang-bang?

Jean Carruthers: Oh, I injected her with Botox.

SZ-Magazin: The receptionist had Botox injected to her like a guinea pig?

Jean Carruthers: You mustn`t forget that it is highly diluted. The receptionist was not in the least worried because I had treated uncontrollable blinking in my patients with Botox for many years.

SZ-Magazin: Did you then treat your own wrinkles with Botox, too?

Jean Carruthers: Of course. I can say that I have not frowned since 1987!

SZ-Magazin: Could you imagine at the beginning that your discovery would change the world?

Alastair Carruthers: Yes, but you don`t really know until it actually happens.
We could observe the fantastic effect of Botox on our patients. But we could not foresee the treatment of depression or migraine or other pain syndromes.

Jean Carruthers: It is a revolution. Botox is ingenious, not only because people do not need surgery. You don`t have to tell anybody that you had something done. It is absolutely discreet.

SZ-Magazin: How does one feel who has changed the world?

Jean Carruthers: We are proud that it is helpful for so many people. And it is nice to have something positive attached to our name.

SZ-Magazin: As you did not earn billions with your discovery, do you at least get recognition for it?

Jean Carruthers: Colleagues ask us for advice. We speak at conferences all over the world. Oprah Winfrey mentioned us. But are we met with adulation in the streets? No, but when we go to a restaurant in Vancouver, we know a lot of people. Our patients, of course!

Alastair Carruthers: They look the other way and we look the other way. But in Brazil we are treated like stars. When we are in Brazil, it is reported on the news.

SZ-Magazin: Why is that?

Jean Carruthers: Oh, it is wonderful. In Brazil, people understand the importance of appear-ance. In North America, Europe and Asia, people still think that appearance is more a luxury than a necessity. They mix up the words “self-esteem” and “vanity”.

SZ-Magazin: But some people go really too far in wanting to look young, don`t you think?

Jean Carruthers: I don`t think that they always want to look like they are again 16. They want to look fresh, empowered, ready for action, cheerful. Nobody wants to look tired and dispir-ited. Today you have to look your best in order to keep your job. But there is very good evi-dence that when we look angry, depressed or worn out, people treat us more negatively. I didn`t make this up. That is how people are psychologically wired.

SZ-Magazin: But some people look overdone, surely you see that too.

Alastair Carruthers: I don`t know where these people live, in Manhattan maybe or in Beverley Hills? In our practice, we don`t see these people.

Jean Carruthers: It is rare that people come to me with unrealistic expectations. In this case, I sit down with them and say: “You look fabulous right now and if we do more, you will look overdone.” I am for slight undertreatment so that it looks natural.
For example if you have somebody to treat their brows, maybe you don`t treat their crows feet. Or I treat somebody`s cheeks but not their naso-labial fold.

SZ-Magazin: Is our botoxed ideal of beauty not dictated by Hollywood, a globally uniform ideal that is spread by the media? Do we all have to look like Demi Moore?

Jean Carruthers: No. Most women want to look their best for themselves. Not younger, just age-appropriate.

SZ-Magazin: But women are increasingly under enormous pressure to have faces without wrinkles.

Jean Carruthers: Nobody is forced to use Botox. If people choose not to maintain their ap-pearance, then they should not be disappointed to be treated differently. Ageism is creeping in as well.

SZ-Magazin: Some people have Body Dismorphic Disorder: They cannot stop having changes to their bodies.

Jean Carruthers: You recognise these people. They need help. I usually refer them to a psy-chologist.

SZ-Magazin: What is the future of the cosmetic botox treatment?

Alastair Carruthers: The Holy Grail is the Botox cream, easy to use and safe.

SZ-Magazin: Has there been research done for a Botox cream? How far is it?

Jean Carruthers: The clinical tests of Phase 1, 2 and 3 are done. It is now before the FDA waiting for approval. It is a gel that can be placed on the skin for a certain amount of time and then you can gently wash it off. One can see results in 2 to 5 days. Botox cream can also be very helpful for excessive sweating or back pain.

SZ-Magazin: Would you treat very young people who don`t have wrinkles yet, with Botox?

Alastair Carruthers: If their reasons were understandable. If they were frowning all the time and would get lines on their forehead… why not? I treat adolescents with Botox against sweating because it is a big problem for them and they are easily embarrassed.

SZ-Magazin: Mr. Carruthers, was your wife`s beauty important to you when you first dated?

Alastair Carruthers: I liked the total package. I wanted an equal partner at my side.

SZ-Magazin: You work in the same building in Vancouver but in separate practices. Why?

Jean Carruthers: Because we prefer to stay married.

SZ-Magazin: Can you tell me something positive about getting old?

Alastair Carruthers: It is the experience we have that makes life so much more interesting.

Jean Carruthers: But I still think we do not have to simply accept the deterioration that poten-tially goes along with aging. Maintenance is necessary whether we are speaking of our faces and bodies or indeed a bicycle or car.

SZ-Magazin: But you cannot rejuvenate your brain with Botox.

Jean Carruthers: But you can get new brain cells when you exercise. I have sold my car, I cy-cle or walk to the bus. We love to snorkel and we learnt surfing in Tofino.

SZ-Magazin: Why are you so down-to-earth?

Alastair: As a dermatologist, I have treated skin cancer for 20 years and Jean has saved the eyes of many children.

Jean Carruthers: We have each other and our expanding family.