The Canadian Story Behind Cosmetic Botox
In 1987, Dr. Jean Carruthers, a Vancouver-based ophthalmologist, was using botulinum toxin to treat muscle spasms around the eyes when one of her patients noticed something strange. She told the doctor, "When you inject my forehead, my wrinkles go away."¹
Dr. Jean Carruthers shared the observation with her husband, Vancouver dermatologist Dr. Alastair Carruthers, saying, "You know, I think I have something for your cosmetic frown line patients."²
At the time, Dr. Alastair Carruthers was treating frown lines with collagen injections, but the results were often inconsistent and short-lived.
At first, the idea was met with considerable skepticism. As Dr. Jean Carruthers later recalled, "Our colleagues, I would say, were uniformly horrified by this."³
Despite the skepticism, the Carruthers continued their research. In 1991, they presented their findings at the American Society for Dermatologic Surgery Annual Meeting. The following year, they published a study showing that 16 of 17 patients experienced an improvement in their frown lines, with results lasting between three and eleven months.
Interest in the treatment grew rapidly. By 2002, Botox received FDA approval for the temporary improvement of frown lines, helping transform a treatment originally used for muscle disorders into one of the most widely recognized cosmetic procedures in the world.
For Dr. Mark Godley, the story of the Carruthers' discovery reflects a period of significant change in medicine. Dr. Godley and Dr. Alastair Carruthers were colleagues in Vancouver during the years that cosmetic Botox was beginning to gain attention. Both were working in a field that was evolving quickly, with new techniques, treatments, and ideas emerging every year.
"We would often run into each other professionally," says Dr. Godley. "There were a lot of controversial changes happening at the time."
While the Carruthers were researching the cosmetic use of Botox, Dr. Godley was building his career as an anesthesiologist and entrepreneur.
He would later found False Creek Surgical Centre in Vancouver, a facility known for cosmetic procedures as well as specialist and surgical services. The concept wasn't universally embraced. Some viewed private surgical facilities as a challenge to Canada's healthcare system, while others saw them as providing a choice for people struggling with long wait times or seeking care outside the country.
In many ways, it's easy to see why Dr. Carruthers and Dr. Godley frequently crossed paths professionally. Neither physician was afraid to explore new approaches, even when those ideas were met with skepticism.
Today, Botox is so widely used that it's easy to forget how unconventional the idea once seemed. What began with a patient's observation, a skeptical medical community, and two Vancouver physicians willing to pursue an unusual idea ultimately changed aesthetic medicine around the world. Not bad for something that many of their colleagues initially thought was a terrible idea.
Dr. Alastair Carruthers passed away in August 2024. His work continues to influence aesthetic medicine today.
1,2: Journal of the American Academy of Dermatology: The Legacy of Dr Alastair Carruthers: Pioneering Botox and transforming dermatology https://www.jaad.org/article/S0190-9622(24)03027-5/fulltext
3. CBC News: 30 years ago, this Vancouver doctor pioneered use of Botox for cosmetic purposes https://www.cbc.ca/news/canada/british-columbia/30-years-ago-this-vancouver-doctor-pioneered-use-of-botox-for-cosmetic-purposes-1.4441116
