A blog by Los Angeles dermatologist and liposuction Surgeon, Dr. Osman

Since its discovery that it could reduce facial wrinkles over 10 years ago, Botox has revolutionized aesthetic medicine.  It has helped millions of people look and feel better, and it is now a household name.

Despite how many people know about Botox, I am always surprised to hear the myths patient’s have about it.  In a few minutes, I’ll dispel the most common myths that I hear from patients.

For the purposes of this discussion, I’m referring to all botulinum toxin products when I refer to Botox.  The other botulinum toxin products on the market are Dysport and Xeomin, and the same myths apply to these products as well.

Myth #1: Botox will make your wrinkles worse if you stop

Botox does not make your wrinkles worse if you stop.  In fact, Botox may actually lessen your wrinkles if you stop.  That’s because, for some people, Botox re-trains their muscles not to contract so much thereby lessening the wrinkles caused by muscle contraction.

What Botox can do is accentuate new wrinkles in some people by changing the way the muscles of the face contract.  When one muscle is paralyzed by Botox, another may strengthen to try and compensate.  If Botox is done carefully by a skilled injector, the risk of this happening is minimized.

Myth #2:  Botox causes the face to sag

This is absolutely false.  Sagging of the face is caused by loss of facial volume and loss of collagen support in the skin.

If not done properly, however, Botox can temporarily paralyze the muscles that lift the corners of the mouth when smiling.  If these muscles are paralyzed, it can give the appearance of sagging.  This is a very rare occurrence when Botox is done by a skilled injector.

Myth #3:  You should not get Botox if you are older than 65

This myth exists because the FDA approved Botox Cosmetic for patients younger than 65.  However, Botox is used all the time for patients over 65.

When a drug gets approved by the FDA it is within strict guidelines.  This may be because the FDA has concerns about the safety of a drug when it first comes out or because the company studying the drug only studied it in certain populations.

Although, I don’t know for sure, I suspect that Allergan, the makers of Botox did not study it in patients older then 65 extensively enough to satisfy the FDA’s requirements.  This may have been a financial decision.

When a drug is used to treat someone outside of FDA guidelines, it is said to be used “off-label”.

I treat patients older than 65 commonly with Botox.

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