Secret Botox: A betrayal of trust or just a little white lie?

For eight years, Sophia* has been living a double life. She is not cheating on her husband and isn’t doing anything illegal, but her clandestine activities are something she plans with military precision to avoid getting caught.

Sophia, who is in her early 30s and lives in north London, is hiding her secret in plain sight. She is one of the hundreds of thousands of Brits who get non-surgical cosmetic treatments every year and lip filler is her beautifier of choice. But her husband doesn’t know.

Welcome to the world of cosmetic infidelity.

It started with a small amount of filler in her top lip. Then she had to go back to discreetly top it up. Before she knew it, she was hooked. She has a separate bank account, which helps cover her tracks, and she plans appointments around her husband’s football practice. She makes sure they’re first thing in the morning, in the hope the swelling will reduce by the evening. But it’s not always easy to keep it secret.

“It doesn’t matter what time of day you get lip filler, by the evening you look like a baboon’s backside,” she says.

Sophia just needs 24 hours or so for the swelling in her lips to subside, leaving her with a plump but natural-looking pout. But in that tricky transition period? “I get into bed and pretend I have period pains while covering my mouth under the duvet in the dark, with just the TV on.”

Honesty is not an option, she says, as her husband has made it clear he is against cosmetic treatments. “Or so he thinks,” she adds, recalling him telling her how pretty she looked after one procedure. “I think men assume you’ll look over-filled and I can’t be bothered to argue. I’d rather hide it, it’s a lot easier.”

Whether it’s Botox, fillers or other injectables, there are lots of Brits giving their natural beauty a helping hand with “tweakments” – but the majority, according to practitioners, are keeping it secret from their partner or other significant people in their lives. While most people in relationships tell the odd white lie here and there, is hiding the truth about cosmetic work a betrayal of trust – or is it a case of your body, your business?

Justifying the money was one of the reasons given by the secret tweakers we spoke to. Injectables don’t come cheap in a cost of living crisis, with the NHS saying prices vary from about £100 to £350, depending on the clinic and the area being treated.

There’s also societal pressure, especially on women, to look effortlessly wrinkle-free – but do this naturally, please. And so the occasional post-treatment bump or bruise might be blamed on children, pets or cupboard doors – one woman even convinced her husband he had injured her in his sleep.

Once a preserve of the rich and famous, an estimated 900,000 Botox injections are now carried out in the UK each year, according to the government. Skin boosters, which hydrate and add moisture, are also growing in popularity, and a recent report in a British plastic surgery journal predicted the UK injectables market will reach a value of £11.7bn by 2026.

The world is becoming more open about it, with influencers often filming their treatments to show how it all works. Love Island star Zara McDermott and former Made In Chelsea star Millie Mackintosh are among the British influencers who have been open about their injectables.

And yet, for many of those investing in these treatments there is still a stigma attached to it.

Pamela*, a 34-year-old mum from southwest London, has Botox in her forehead and between her eyebrows. For years, she kept it secret from her husband, including when they lived abroad in a country where treatments weren’t always up to scratch.

“Sometimes my husband would look at me like he knew something was different but he couldn’t identify what,” she says. “And these were not good Botox jobs either.” On one occasion, she says she was left looking like Dr Spock. “My eyebrows shot up… it was so bad, an absolute shocker.”

Still, even with vampiric brows, she managed to hide it. Her husband had previously told her she would be wasting money and that she “didn’t need it”. So she always paid cash. “I couldn’t leave a trail,” she explains.

Once after a less successful trip to her injector she was left with bruising so bad that no amount of make-up could cover it up. “I convinced my husband he’d elbowed me in the middle of the night and given me a black eye,” she says. “He felt so bad about it.”

Dr Rina Bajaj, a London-based relationship and counselling psychologist, says honest communication is crucial in any relationship – but individuals also have the right to make choices about their bodies.

“In relationships that value individual freedom and independence, these choices may be seen as personal and not necessarily shared information,” she says. But, in a different kind of relationship, one partner discovering the other has been keeping cosmetic procedures a secret can break trust.”

Understanding the motivations behind the secrecy is important, she adds, as if fear of judgement or negative reactions from a partner is a driving factor, it could be indicative of underlying issues.

But fellow behavioural psychologist and relationship coach Jo Hemmings says keeping small cosmetic procedures secret from a partner is an omission rather than a lie. “It’s not a betrayal of trust because you’re doing it for yourself,” she says. “You’re not deceiving somebody else in the way you would be if you were cheating.”

Even the A-listers are doing it. Oscar-winner Olivia Colman has previously said she tried Botox and “LOVED IT” in an interview with The Times in 2015, but admitted to initially keeping it from her husband. “For about six months he kept saying, ‘Hello, Pretty!’,” she told the newspaper. When she eventually told him, “he found it hilarious”.

Botox and other skin boosters remain a complicated issue for many. For every influencer, beauty journalist or celebrity speaking openly about their cosmetic work, there are more insisting their never-ageing faces are down to the magic formula of drinking lots of water and mindfulness.

Paula*, a 43-year-old mum from Hertfordshire, started getting Botox for her “Gordon Ramsay” frown lines after discovering some friends had been doing it “for years”. After her first treatment, she was nervous her husband would notice, but he didn’t. “I panic every time but he’s not the most observant.”

At the other end of the spectrum, Anna, 40, is open about her Botox and fillers with her husband but doesn’t volunteer the information to friends. “I try not to do the school run for the next couple of days,” she says. “Maybe because I’m a mum, there’s a kind of pressure to dress a certain way and not enhance yourself.”

While practitioners say it is more common for women to keep their treatments hidden, there are a fair few male patients telling white lies about their beauty habits.

Simon*, a 60-year-old man who lives in the home counties, has been with his partner for 24 years. In that time, he has had a cocktail of treatments, including Botox, fillers and BBL (Brazilian Butt Lift), as well as tightening and fat-reducing procedures.

It’s a lot to keep quiet about, but he wants his partner to think his youthful looks are all down to his healthy lifestyle. Is he ever worried about him finding out? “Not at all, blind as a bat.”

But it’s not just his partner he keeps it secret from. “Everyone,” he says. “It all looks so natural and I don’t have giveaway scars round my ears or missing bits of my face. They just think it’s the Peloton and smoothies.”

Euan Mackinnon, a maxillofacial surgeon and aesthetic doctor who treats cosmetic patients at The Lovely Clinic, has been carrying out tweakments for more than 10 years and says about 70% of clients are keeping it secret from someone.

“There’s a lot of people who are worried about being found out by a partner,” he says. It is usually women not wanting their husband or boyfriend discovering their secret, because men will give examples of celebrity horror stories, not realising there are hundreds for whom it has gone well. Men fear their partners looking caricature-like, “with overly inflated lips or frozen foreheads”, he adds. “In reality, that’s not what we do at all.”

Read more:
How to make Botox and other non-surgical cosmetic treatments safer?
Two-thirds of cosmetic surgery injections not carried out by doctors – study
Botulism in patients who had weight loss injections sparks warning

Patients will often tell him excuses they have given for any temporary bruising that might occur immediately after injections. “You do what you’ve got to do to get through those first few days. But most treatments don’t lead to significant bruising.”

On a more serious note, patients are worried about being judged, he says. “Partners might make them feel like they’re being silly or being vain… But you shouldn’t feel shameful if you look in the mirror and you just don’t like something… if there’s a very safe solution to that problem then why not make yourself feel good?”

There are also contradictory societal pressures, he says: age gracefully, but don’t age. “It seems to be a success to look incredibly good and have had nothing done because you’re winning at life, and if you have some help along the way it’s seen by some as cheating or a weakness – which it’s obviously not.”

And there is a difference across generations. Younger millennials have grown up watching influencers filming from their beauty beds as the needles go in, and are more likely to view cosmetic treatments as self-care. Older millennials, Gen X-ers and Boomers are more likely to keep it private.

“But it’s not just a vanity project,” Mr Mackinnon adds. “I’m constantly seeing patients who tell me their confidence has improved – ‘I got this promotion’, ‘I took the plunge with something’ – it can change everything for them.”

Lee Garrett, advanced aesthetic nurse practitioner and prescriber and clinical lead at The Cosmetic Skin Clinic, carries out about 3,000 treatments a year and has more than 20 years’ experience in the field.

He agrees it is common for patients to keep treatments secret from partners, and work colleagues as well – some have even told him that working in a very young environment makes them worry about their looks and being “pushed out by a younger version”.

Secret or no secret, both Mr Mackinnon and Mr Garrett agree the most important thing is to do your research and go to a healthcare professional. “Avoid at all costs people who say they can do it cheap,” says Mr Garrett. “They can, but they are not qualified, not insured and so when it goes badly wrong, you’re on your own.”

And if that happens, the secret definitely will be out.

Meanwhile, Sophia is hoping to get beauty vouchers for Christmas to cover her next lot of secret lip filler. Last time, her husband thought he was gifting her a facial. “He asked me how it went and I responded, ‘really relaxing, thank you!'”

Cosmetic infidelity, it seems, is a hard habit to shake.

*Names have been changed