My Friend’s Botox Looks Bad. Can I Say Something?

Welcome to Asking for a Friend, an advice column that helps you make sense of your messiest, most complicated friendship moments. Each month, clinical psychologist Miriam Kirmayer, PhD, will answer readers’ burning—and anonymous—questions. Got one of your own? Ask Dr. Miriam here.

Dear Dr. Miriam,

My friend has gotten a lot of injectable work done over the years—and to be honest, I think it looks really overdone. I’ve even heard people talk behind her back, saying she looks “botched,” which breaks my heart.

She’s never directly asked for my opinion, which is why I’ve never had a natural opening to share how I feel. But as she continues getting more and more tweakments, I can’t help but feel conflicted. Am I a bad friend for staying quiet? I care about her and would like to be honest, but I also don’t want to hurt her feelings or make her feel judged and unattractive. At the same time, if I do say something, how do I bring it up in a way that’s kind, supportive, and not critical? I want to be mindful that maybe she’s dealing with her own insecurities.

—Injecting Some Honesty

Injecting Some Honesty,

Your motivation to protect your friend, your consideration of her potential insecurities, and your curiosity about how to best support her shine through. No, you are not a bad friend. You sound like a concerned friend.

I also hear your concern about how to avoid coming across as critical. I say this with a heavy dose of compassion and understanding: You already are.

The belief that your friend has taken her “tweakments” too far is already a value judgment, since beauty, appearance, and attractiveness are always rooted in subjectivity. Consider this: Would you question her confidence if she were to dye her hair a new color? To get a new tattoo or another piercing? What if her lips were not “overfilled” but consistently overlined? Of course, each of these carries different levels of risk and permanence. But if you were to survey enough people, chances are you would end up with a variety of responses and judgments. Would less frequent appointments have you feeling less concerned? What’s the threshold at which a “tweak” enters into insecure territory?

This can be a worthwhile thought experiment because it highlights that what we see as obvious is far more personal, not to mention cultural, than we assume.

So, what should you do? While you may not be alone in disapproving of her decisions (as you pointed out), you can stand out as the type of friend you choose to be.

What I mean is, shift your focus away from her appearance and towards her actions and their possible consequences. Aside from her looks, what are you specifically worried about? Are you afraid that an escalation may lead to medical procedures that can compromise her health? Is this causing financial stress in her life? Perhaps this is leading to relationship difficulties and highlighting potential rifts in other friendships?

Your concern about her self-worth is an important and interesting one. I wonder, are there other behaviors of hers that lead you to question whether this is rooted in low self-esteem? How has she responded to feedback or “check-ins” about her well-being in the past? Regardless, focusing on her behavior as opposed to her appearance can help you decide if there is genuine cause for concern—or if your critique is best kept to yourself.

Now, if you choose to go the route of giving direct feedback, it’s important to stick to the facts: I know you’ve started going to more regular appointments. I want to make sure this is something that still feels good and fun! You can also lead with your own experience and/or vulnerability: I don’t know about you, but sometimes I find it hard to feel completely confident in or content with my own body. Totally get if this is just about experimenting and feeling good, but if it’s coming from a place of not feeling so good, I’m here to listen.

If she starts to open up or you decide to press further, you can say: I want you to know I’m here to listen, to remind you of your inner and outer beauty, or to share some ideas for what has helped me in the past. You never know exactly what a friend will actually find supportive. (I’ve even heard of similar situations where the response deemed most helpful was a referral to a better or more qualified clinic.)

It’s also worth questioning what your relationship with “body talk” is—including whether you’re in the right mental space to talk about potential insecurities that may shine a light on your own. If not, it’s also okay to not take on this responsibility. Your concern does not always need to be acted on. And in some situations, learning to tolerate our own distress or disappointment is the most helpful thing we can do.

Finally, how you act “behind her back” is equally important and may be another way to show your support. When you hear others commenting on her looks, you can step in and say something like: I’m not okay with you talking about my friend in that way, or I’m not in the habit of talking about people when they aren’t around. Can we talk about…[literally anything else]? If that feels too strong, a simple This isn’t a conversation I’m willing to have, or I’d prefer that we change the topic now should do. (And no, you don’t have to let her know that others are gossiping.)

As tough and uncomfortable as this kind of conversation might feel, it’s clear to me that your intention is to preserve your connection (as well as your friend’s well-being). So just remember that honesty isn’t necessarily about blurting out whatever judgment is on your mind—or holding someone else to your own standards about beauty. It’s about choosing words and expressing your concerns with care, whether that’s with your friend or standing up for her “behind her back”—and hopefully, the scripts above give you a sense of how to do that a little more thoughtfully.