Botox Cosmetic Injections: 10 Common Myths Exposed

wrinkles - botox

By Melissa L. Giordano, RN, CANS, CPSN
The Breslow Center For Plastic Surgery
Paramus, NJ

Botox is one of the most common anti-aging procedures worldwide, yet despite its popularity and proven track record, several misconceptions surrounding it persist. Here are 10 common Botox myths we often hear at our practice.

1. Botox is toxic and unsafe

As a purified derivative of botulinum protein, Botox is completely safe for cosmetic use. The amounts injected are nowhere even near toxic levels. This misconception that Botox is toxic and unsafe is largely due to the fact that Botox derives from botulinum toxin, most commonly associated with food poisoning.

No long term side effects have ever been reported in Botox users, despite the millions of treatments performed throughout the world over the past 20 years.

2. Botox treatments are extremely painful

Although getting treated with Botox involves multiple injections, most patients typically experience little to no discomfort. The needles are extremely small and go just below the surface of the skin. A slight pinching sensation may be felt, and while there are topical numbing creams that may be used prior to Botox treatments, most patients do not even find this necessary.

3. Botox and dermal fillers are the same

While Botox and dermal fillers both diminish lines and wrinkles, they work quite differently. Botox relaxes the muscles that are responsible for facial expressions such as forehead lines, frown lines and crow’s feet. Dermal fillers essentially plump up areas that have lost volume such as the cheeks and lips, and fill deeper folds or creases in areas such as the smile lines and marionette lines.

4. Botox makes you look frozen or emotionless

Botox is a technique-sensitive treatment. When injected by the hands of a skilled practitioner, Botox should never make you look emotionless or completely frozen. Botox only relaxes muscles at the point of injection, which means that it cannot completely inhibit facial expressions. The goal is to look refreshed and natural, not “over-done.”

5. Once you’ve had a facelift or eyelid lift, you’ll no longer need Botox

Even after surgery, strong facial muscles responsible for lines and wrinkles will typically still benefit from Botox. While it’s the patient’s choice whether or not to continue with Botox, most who’ve undergone cosmetic facial surgery are much more satisfied with their surgical outcomes if they keep up with their regular Botox treatments.

6. It’s safe to have anyone inject Botox

While Botox is a simple and safe treatment, it isn’t something that should be done by just anyone, anywhere. It is a medical procedure and your results are largely dependent on the skill of your healthcare professional. Healthcare professionals who are qualified to inject Botox include Physicians, Physicians Assistants, Nurse Practitioners, and Registered Nurse Injectors. The treatment should only be performed in the professional setting of a medical office where the appropriate safety measures are taken.

7. Botox is permanent

Botox provides temporary results, which is one of the reasons why it’s so safe! The muscles under the skin typically start to move again after 3 to 6 months and the wrinkles will gradually return. The effects of Botox may last shorter or longer, depending on the patient. Should you choose to maintain your results, repeat treatments are typically recommended every 3 to 4 months.

8. Botox is only for women

Botox is an excellent anti-aging treatment for both men and women. Typically, men may require a higher dosage of Botox due to stronger facial muscles. In our practice, we have noticed that more and more men are seeking treatments with Botox every year.

9. If I stop using Botox, my wrinkles will look worse

Once the effects of Botox gradually fade away, facial muscles regain the mobility they had before the treatment. The lines you had prior to your treatment will start to return gradually, but not worse.

10. Botox works immediately

We wish Botox worked that quickly! The onset of Botox is gradual – it usually takes 3 to 5 days to see some subtle results and by 7 to 10 days it will look even better!


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