Jean Carruthers, MD, FRCSC, FRC(OPHTH), remembers the ‘A-ha!’ moment when she realized that neuromodulators could transform cosmetic medicine.
It was the 1980s, and Dr. Carruthers wasn’t a cosmetic physician. She was an ophthalmologist. She had injected a patient with a neuromodulator to treat her blepharospasm, a painful and debilitating condition where people spasm in their eyelids, face and sometimes the neck and arms.
The patient, Dr. Carruthers recalls, was angry.
“She pointed at her inner brows and said, ‘You didn’t treat me here,’” Dr. Carruthers says. I apologized to her, saying, ‘I’m sorry but I didn’t think you were spasming there.’ And she responded, ‘I know. I’m not spasming there, but every time you treat me there I get this beautiful untroubled expression.’”
That day, in her clinic with the angry patient, Dr. Carruthers was inspired. She thought about how her cosmetic dermatologist husband Alastair Carruthers, MA, BM, BCh, FRCP(LON), struggled to treat the aging face with often sub-optimal options of collagen-based fillers and fat.
“Those options only supported the folds in the skin, they didn’t give any relaxation to the musculature in the region,” Dr. Carruthers says.
She went home that night and said to her husband, “You know, I think I have something for your cosmetic frown line patients.”
And that’s how it all started: The discovery that would change the course of Dr. Carruthers’ career.
“Once you see what botulinum toxin can do, it is like somebody flicked a switch on in a previously dark room,” Dr. Carruthers imparts. “At that point I was an ophthalmologist who subspecialized in misaligned eyes (strabismus) and pediatric ophthalmology. I found that after a couple of years I actually gave all of my patients to my lovely colleagues, so I could continue in the cosmetic world.”
Jean and Alastair Carruthers wrote the first published paper on the cosmetic use of neuromodulators in 1992 in the Journal of Dermatologic Surgery and Oncology1. They are credited with discovering the cosmetic use of neuromodulators, which led to the launch of the first neuromodulator in aesthetic medicine: Botox from Allergan.
When asked what she’s most proud of in her career, Dr. Carruthers says pioneering what has become the most commonly used cosmetic procedure worldwide, probably ranks first. But there are many other things that Dr. Carruthers says make her proud. Among those, pioneering new ways to use fillers, and new ways to use neuromodulators, fillers and energy-based devices in novel treatment combinations to achieve an enhanced aesthetic result for the patients.
She continues to be fascinated with, and conduct research on, treatment side effects that end up being absolute benefits to patients.
“For example, CoolSculpting (Allergan) is a wonderful skin tightener, but nobody talks about that,” Dr. Carruthers points out. “It would be such a terrible trade to kill the fat and be left with a little hanging empty sack. But you aren’t. And that is a beautiful thing.”
In fact, Dr. Carruthers and colleagues published a study on cryolipolysis and skin tightening in Dermatologic Surgery in 20142.
Advice to women in aesthetic medicine
Dr. Carruthers says her number one message to women in aesthetics is to listen to patients.
“Listen carefully. They’ve thought about things; they’ve researched them. They’re actually quite well informed,” she notes. “The second thing is people don’t do what you tell them to do; people do what you do. Look the part. Look after yourself. Be fit. Be generous. Patients are going to want to emulate things that you do rather than things that you tell them to do.”
As for her favorite tip when using neurotoxins in cosmetic practice, Dr. Carruthers says always slightly underdo people, and they’ll look fresh and natural.
At 71, Dr. Carruthers says success comes from surrounding oneself with positive people, including those who work in the practice. And doctors, themselves, need to be positive. Because what goes around really does come around, she says.
The reality is women need to be prepared to work really, really, really hard, Dr. Carruthers says candidly.
“I think women in medicine in general, and in aesthetics, have to work harder than men, even nowadays. I think it is just a cultural thing. I think it works, though. I’ve had several mentees who have gone on to do amazing things because they have such a strong work ethic,” she says. “I like to get up early in the morning. I get up at 4:30 am every day and workout for an hour and a half because that sets me up for the day. It makes me feel so positive about the day and thus to everybody in my day.”
Dr. Carruthers continues to do research and clinical work at her practice in British Columbia, but on a part-time basis. Dr. Alastair Carruthers is retired from dermatology practice and is back at school, earning an undergraduate history degree at the University of British Columbia.
The couple, Dr. Carruthers says, is traveling and enjoying their family, including four grandchildren.
“What I’m doing now is trying to devolve myself into more of a consulting role in terms of research. So, I’m going to meetings and working on new scales, for example,” says Dr. Carruthers who has published several papers on the use of different scales in aesthetic medicine. “I’m also working on a little invention that measures the elasticity of human skin. And I’m just working on keeping my family as healthy and happy as they possibly can be.”
Good to know
Q: What is your favorite travel destination?
I think I have to say London, England is my favorite long-distance travel. Everything is there. It is so cultural. The vibe is really great. London has to be one of the greatest cities in the world. For a smaller destination which is really fun with so much to do is Whistler, British Columbia.”
Q: What’s your favorite music or song?
I have a lot of different tastes in music. I like the Bach B Minor Mass. I like Greensleeves written by Henry VIII, and I like some Ringo Starr songs. I think he is the most amazing Beatle.
Q: What is your favorite quote?
A Chinese proverb: ‘Water can float the boat. Water can also sink the boat.’
Q: Do you have a favorite author or book?
I like the Hobbit (J.R.R. Tolkien) and Winnie the Pooh (A. A. Milne) because both books are so positive. Maya Angelou for her wisdom, Marie Curie for her brilliance and perseverance in a time when women had such limited occupational status.
Q: Who is your role model?
My mother was a doctor and I learned an awful lot from her about how to run a family and practice. The other is one of my father’s colleagues, Dr. Lorrie Dolman. She also was a very busy doctor with three children. That is an amazing thing to learn from a woman who is managing to keep it all going by being positive, kind and supportive to other people; so that she ends up being able to trust and delegate to others, rather than going crazy trying to do everything herself.
References:
1. https://www.ncbi.nlm.nih.gov/pubmed/?term=treatment+of+glabellar+frown+lines+with+c.+botulinum-A+exotoxin
2. https://journals.lww.com/dermatologicsurgery/Abstract/2014/12001/Cryolipolysis_and_Skin_Tightening.13.aspx
