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Stop Looking So Mean & Angry: How to Reverse Resting Bitch Face

Summary: Resting Bitch Face is something that plastic surgeons have seen for years.
Air Date: 6/12/15
Duration: 10
Host: Leigh Vinocur, MD
Guest Bio: Lyle Back, MD
Lyle Back HeadshotOriginally from New York City, Dr. Lyle M. Back, M.D., F.A.C.S., graduated with honors from Rutgers Medical School. He completed his surgical training at Ohio State and is an ABMS Board Certified Surgeon in both General Surgery (ABS) and Plastic Surgery (ABPS). Dr. Back is a Fellow of the American Academy of Cosmetic Surgery (AACS) and a longstanding member of the American Society of Plastic Surgeons (ASPS).

Dr. Back has served as a professor of Plastic Surgery at Temple University and St. Christopher's Hospital for Children in Philadelphia and has performed reconstructive surgery with "Operation Smile" in Vietnam.

Dr. Back's numerous articles on Cosmetic Surgery and Plastic Surgery have appeared in leading medical journals and popular magazines. Dr. Back is frequently featured in local newspapers and magazines and often appears on radio and television programs. Over the years, he has hosted several live radio and TV shows on Cosmetic Surgery in the Delaware Valley. He has lectured extensively and received many awards for his teaching and training of young surgeons across the country.

Dr. Back has received numerous local honors such as "Top Doc" Plastic Surgeon. Dr. Back is listed in the Guide to America's Top Surgeons by the Consumer's Research Council of America. He is also listed among "America's Cosmetic Doctors and Dentists" in the Castle-Connolly Directory and in The Consumer Guide to Plastic Surgery. He is a highly respected member of the most prestigious local and national surgical societies.

Dr. Back is a well known Cosmetic Surgeon and has been in the Philadelphia area in private practice for over 20 years. He specializes in the full range of the most modern, state-of-the-art cosmetic surgery procedures and non-surgical cosmetic enhancement techniques available today.
Stop Looking So Mean & Angry: How to Reverse Resting Bitch Face
"Resting Bitch Face" is a label given to women who look mean, unintentionally.

The term might have started off as a joke, but many women are identifying with this phenomenon.

This condition actually exists. The severity depends on the shaping and lines of your face. For example:

  • Thin lips = mean, older, strict/stern
  • Lines/folds around the mouth or down from the corners = mean, unapproachable, unfriendly, harsh, scowling
  • Beady, non-open looking eyes = shifty, tired, uninterested, apathetic, bored/boring
  • Deep folds/lines between the eyes = angry, grouchy, stern, scolding
  • Low, flat arched eyebrows = tired, stressed, exhausted
  • Too-high arched eyebrows = giddy, ditzy, hyper
  • Low eyebrows folded towards the center = judgmental
  • Large, non-refined or bottom-heavy nose = masculine, non-feminine, rough, older

What can be done to each feature to combat Resting Bitch Face?

Lyle Back, MD, joins Dr. Leigh to discuss what resting bitch face is and how you can reverse it.

RadioMD Presents:Dr. Leigh Show | Original Air Date: June 12, 2015
Host: Leigh Vinocur, MD

RadioMD. RadioMD.com. Emergency physician, TV personality, speaker, and writer. She's Dr. Leigh. It's time for the Dr. Leigh Vinocur Show.

DR. LEIGH: Hi and welcome to the show. This is Health from the Outside In. It's actually vanity's dirty little secret, where feeling good actually starts with looking good. So, it's very apropos. My next guest, Dr. Lyle Back, is a well-known cosmetic surgeon in the Philadelphia area. He's been in private practice for over 20 years.

Well, thank you, Dr. Back, for being on the show. He's going to talk about something very interesting. It's to help women stop looking – or men – so mean and angry; how to reverse that "Resting Bitch Face."

DR. BACK: Oh, boy. Yes. And thank you so much for having me on the show, even though that's kind of a rough title to the subject matter.

DR. LEIGH: Yes. I'm sure we're going to get all kinds of calls, but, you know, this is a little tongue-in-cheek, too. [laughing]

DR. BACK: Of course.

DR. LEIGH: So, let's talk about it, because aging is not fun. It is better than the alternative; I'll give you that. But a lot of things happen to our face when we age. Describe some of the things that are happening that have been coined kind of the "Bitch Face" or "Resting Bitch Face."

DR. BACK: Well, you know, one of the things I want to tell you is that a lot of people think of plastic surgeons, cosmetic surgeons, as the doctors you go to in order to look younger. But what's very interesting to me is a lot of people find out that what they were really looking for was to look happier, to look rested, to look like they're comfortable, confident, not so stressed. I've also found over the years that even after people have had surgical procedures, they'll often comment at looking at their before pictures that they looked very tired or angry or stressed.

So, this is not something new and I think maybe for a lot of people they'd be surprised to hear that this is one of the most rewarding and satisfying aspects of having cosmetic procedures is that yeah, you know, we want people to look younger and we want them to look healthier from the outside in, but looking happy and looking like you're contented and feeling that way, those two things kind of play off each other.

DR. LEIGH: And, actually, I do believe it can make you feel that way. There was a study a long time ago – and I think Malcolm Gladwell mentioned it in one of his books – that when people were using the muscles in their face and using repeating facial expressions that were frowns and things like that, they actually became depressed from it.

DR. BACK: Yep. You know, there's been a tremendous number of studies done on this in the Botox era. We've discovered that that old song that we used to hear when we were kids – "Put on a happy face" – it'll make you feel better. You know what? It's actually true. They've studied a lot of what happens to the brain when someone has an angry look, when they smile more, even some of these things we're talking about today: getting rid of the frown lines and things that make you look sad, depressed, or tired. It turns out that if you don't look that way, the brain kind of figures out "Hey, you know what? Maybe I'm supposed to be happy instead of sad." It certainly has been proven now in a lot of studies.

It's really fascinating to find out that looking better--looking happier--actually makes you feel happier. Then, of course, we get that wonderful circle where you look better, so you feel better, so you look better. What a great circle to be on.

DR. LEIGH: Yeah, I definitely believe it. There's such a thing as a "Bad Hair Day." And every woman has gone through it. They know it. When your hair is not looking good, you feel terrible.

DR. BACK: Absolutely. Just this week a woman said to me, "Dr. Back, do you know what it means when a woman is having a 'Good Hair Day'? It makes her day." She said, "The stuff that you do helps us have a 'Good Hair Day' every day." And I thought, "Boy, that's the best." Because really what we are trying to do as cosmetic surgeons is to make every day a "Good Hair Day." Now I don't have any hair, so I can't have a "Good Hair Day," but I understand the intention.

DR. LEIGH: [laughing] Alright, so let's talk about what are some of the things that happen with aging that create this.

DR. BACK: One of the things we see a lot are women and men getting kind of a sleepy look or a tired look. They get a lot of lines in the forehead or between the eyebrows. A lot of times they'll be asked by well-meaning friends or family, "Are you okay? Are you sick? Are you stressed?" You might not feel that way, but when you have kind of a closed, tired, lined look to the forehead – a heavy brow – it can make you look everything from tired, stressed to even somewhat shifty or you're bored, you're uninterested, you look very apathetic. It can make people think that you feel that way about what they're saying, or even about them, just having that kind of appearance around the eyes. And that comes with aging. It also does come with stress, unfortunately.

When you have deep folds between your eyes, it can make you actually look angry, grouchy, stern, somewhat scolding, because these are the lines that we actually use to express those emotions. And when they're there even when you're not trying to express those emotions, you can kind of have an angry look that also kind of dovetails in with that tired, stressed, sort of exhausted kind of look.

Everyone, as they age, tends to develop some lines and folds and shadows, coming from the angle of the nose down to the corners of the mouth – we call those the nasal labial folds. Sometimes folds or shadows or lines extending down from the corners of the mouth to the jawline. These tend to make someone look a little unfriendly, a little harsh, sort of a scowling look or a mean look, maybe even a little bit judgmental and unapproachable. These are normal things that can happen with aging, and often happen just from being on our planet for a few years.

If you don't feel that way – and gosh, I hope you really don't feel that way – to have people looking at you and think that's your mood, is pretty awful. And to have your brain monitoring these things and think that that's the mood it's supposed to be in, can tend to make you be in that mood.

Fortunately, we have some really good ways of turning that "Resting Whatever Face" around.

DR. LEIGH: Okay, so let's hear it. Let's start with the eyelids. What do you do for that?

DR. BACK: One of the best uses of Botox that there is, is around the eyes. This is where Botox has really earned its reputation as the number one cosmetic procedure in the world. Through just a couple of injections – maybe taking five minutes or so in the office – we can get someone to have a more open look to their eyes, a more rested look, less lines between the eyes, a smoother look to the forehead, eyebrows arched up. The bottom line is good injections of Botox can make someone look rested, pleasant, confident. Many patients comment that they feel like they look like they've been on vacation for a couple of weeks and sleeping really well. That's a great look to have; that's a satisfying look to have. [laughing]

DR. LEIGH: I will vouch for that. [laughing] Yes, I'm a big proponent of the Botox. But there is a point – and we only have probably another minute. We could do a whole show on plastic surgery and maybe we will.

DR. BACK: That would be my pleasure, believe me.

DR. LEIGH: You know, it's beyond the smaller things. It's maybe good to start those. Just in a minute, if you're beyond starting those when you're a little younger to maintain, what are the surgical procedures?

DR. BACK: I don't even know that we would necessarily jump right to the surgical procedures but we might jump to the slightly more invasive things, like fractionated laser or micro-focused ultrasound. Things like that. So, there are still a few tricks we've got up our sleeves before we have to go to surgery.

DR. LEIGH: Wow. That is pretty fascinating and encouraging. In the old days, you just had to wait till you were 65 or 70 and get the major face-lift. Now it's all about these new, little devices and lasers and things that can really do it. And I'm a big proponent of trying to maintain, and I agree, it's not trying to look younger, it's just trying to maintain.

I want to thank my guest. This is the Dr. Leigh Vinocur Show, it's Health from the Outside In, on RadioMD.