Your Botox buddy is caught in the trap that our culture and our economy does all it can to set for women. The message = you are most certainly NOT lovable or even acceptable without the interventions and enhancements we're here to sell you, and whatever you buy, it's not enough. It causes such a neurotic inward-pointing focus that people like your friend literally are unable to see that their self-hatred is a commentary on others who aren't as caught up in image vigilance, or who, as you point out, have a non-standard visage for whatever reason. I cannot claim I've never fallen into that trap myself — but at least, after lo these many years, I can recognize it.