Earlier this week, a patient in her thirties came into the office complaining of “resting bitch face”. When I reported that I had never heard of this particular affliction, she gave me a shocked (and somewhat bitchy) look. After I did a little research, I found out that this a well-described phenomenon.
From the Urban Dictionary : a person, usually a girl, who naturally looks mean when her face is expressionless, without meaning to. Nah, she’s just got a resting bitch face, she’s actually really sweet.
Turns out there’s even a facebook support community dedicated to “patients” with resting bitchface syndrome.
So what facial characteristics may cause others to think you’re mad or tired, even when you’re not? The particular patient who introduced “resting bitchface syndrome” to me had thin lips with prominent, downward corners (marionette lines), which she thought made her look more stern, unfriendly and unapproachable. She also had deep lines between her eyebrows and softer lines across the forehead, which she thought made her look angry. Finally, she had low, relatively flat eyebrows; she said other people always ask her if she’s tired.
Obviously, it’s important not to let others’ perceptions of our moods actually cause us to have that mood. That being said, it’s hard not to get annoyed or upset when other people are constantly asking us what’s wrong. We came up with a relatively simple solution to treat this patient’s resting bitch face. To improve her thin lips and marionette lines, we used a facial filler made from hyaluronic acid. In my practice, I most commonly use either Restylane or Juvederm for this purpose, the results from both of which last for about one year. This had the effect of plumping her lips and eliminating the deep depression around the corners of her mouth, making her look friendlier and more approachable. To treat her forehead and brow wrinkles, as well as to raise the eyebrows, we used Botox. Botox paralyzes the muscles that cause these facial wrinkles, as well as the muscles that hold the eyebrows in a flat and low position. This simple maneuver made her look more alert and refreshed.
For older patients suffering from resting bitch face syndrome, surgical solutions may also be appropriate. For patients who look tired, upper and lower eyelid blepharoplasty (eyelid lift) may be appropriate to eliminate excess skin and troublesome “bags” above and below the eyes. Many of these same patients may benefit from facelift, neck lift, brow lift, laser treatments and fat grafting to rejuvenate the face by eliminating jowls, raising the eye brows, treating neck cords and eliminating fine lines and marionette lines.
Ultimately, there’s no single facial characteristic that makes you prone to having resting bitchface syndrome. That being said, if people constantly ask you if you’re tired or angry, even when you’re not, you may be suffering from it. To learn more about potential treatments, contact our office at 214-827-2814 to set up a consultation!