Before we begin — a few numbers
Botulinum toxin type A (in short: Botox, though this is a brand name for one of the preparations) is the most frequently performed aesthetic medicine treatment in the world. In 2024, over 9 million treatments were performed globally (data from ISAPS — International Society of Aesthetic Plastic Surgery). In Poland, the market is growing by over a dozen percent annually.
This is not a niche procedure. It is not an experiment. It is the gold standard of aesthetic medicine with a twenty-year clinical history. But TikTok will not tell you that, because facts are not viral. Myths, however, are.
MYTH 1: "Botox is a poison"
The cosmetic dose of botulinum toxin is about 20–60 units for the entire face. A dose that could pose a threat is a multiple of this amount, administered intravenously — not locally. The proportion makes the cosmetic treatment safe.
Botulinum toxin is also a medicine — used in neurology (dystonia, muscle spasticity), urology (overactive bladder), ophthalmology (strabismus) and the treatment of chronic migraine (FDA-approved). It is a drug with a wide range of medical uses, one of which is aesthetics.
MYTH 2: "Once you start, you cannot stop"
Botulinum toxin does not affect reward receptors, does not change brain neurochemistry and does not cause withdrawal symptoms. When the effect wears off, the muscles return to normal. No new wrinkles appear. Existing ones do not deepen.
Psychological habituation — yes, that is possible. You get used to a smooth forehead and when the effect wears off, you prefer to return to it. This is an aesthetic preference, not a substance addiction. Just as you get used to dyed hair — the roots are not "worse" than the state before dyeing.
MYTH 3: "Botox freezes the face"
Modern aesthetic medicine offers approaches that preserve natural facial expressions:
- Micro-botox — minimal doses, dispersed over a larger area. Result: smoother skin, facial expressions preserved.
- Baby botox — preventive, small doses at strategic points. It slows down the formation of wrinkles without eliminating facial expressions.
- Precise dosing — an experienced doctor selects the dose for a specific muscle. Exceeding it creates a mask-like effect.
MYTH 4: "Botox is for wrinkles"
Bruxism (jaw tension) — do you clench your teeth at night? Toxin in the masseter muscle can reduce tension and alleviate pain. Studies in the Journal of Oral Rehabilitation confirm its effectiveness for this indication.
Hyperhidrosis (excessive sweating) — blocking nerve signals to sweat glands in the underarms, hands or feet. The effect can last from several to over a dozen months. A treatment of significant importance for the quality of life in people with hyperhidrosis.
Chronic migraine — since 2010, botulinum toxin has been FDA-approved for the treatment of chronic migraine (15+ days with a headache per month). Injections at multiple points on the head and neck, repeated every few months.
Drooping corners of the mouth — toxin in the DAO muscle gently lifts the corners of the mouth, neutralising the "sad expression" caused by muscle tone and gravity.
Gummy smile — excessive exposure of the gums when smiling. Toxin in the upper lip levator muscle limits its mobility in a subtle, natural way.
MYTH 5: "If I am 25, I am too young"
Before the age of 25 — expression lines have usually not had time to "set". The skin regenerates quickly enough that folds disappear after the muscle relaxes. In most cases, botulinum toxin at this age is an intervention too early. Exception: a very deep wrinkle between the brows resulting from genetic predisposition and a strong muscle.
27–30 years old — here the discussion about a preventive approach with minimal doses begins. The idea: if a static wrinkle (visible even without movement) starts to set, an earlier intervention can slow this process down.
MYTH 6: "Botox travels around the body"
Studies from Toxicon and the Journal of Neural Transmission confirm: botulinum toxin works locally, within a radius of about 1–2 cm from the injection site. It binds to receptors at nerve endings in that specific place and does not enter the bloodstream in clinically significant amounts.
MYTH 7: "I cannot exercise after Botox"
Intense training within 24 hours after the treatment causes vasodilation and increased blood flow. This can result in greater diffusion of the toxin outside the intended area — e.g., eyelid drooping if the toxin from the forehead moves to the levator palpebrae muscle.
- 24h after the treatment: no intense cardio, gym, hot yoga
- Walking, office work, normal life — without restrictions
- Do not bend over (head below the heart)
- Do not massage the injection sites.
- Avoid saunas and hot showers.
- Do not lie down for the first few hours after the treatment.
MYTH 8: "Cheaper Botox is worse"
- Botox (onabotulinumtoxinA) — Allergan/AbbVie, USA
- Azzalure / Dysport (abobotulinumtoxinA) — Galderma/Ipsen, France
- Bocouture / Xeomin (incobotulinumtoxinA) — Merz, Germany
They differ in their diffusion profiles (Azzalure acts more broadly, Bocouture more precisely) and dosage. One unit of one preparation is not the same as one unit of another. An experienced doctor knows these differences and selects the dose accordingly. The price also varies because Botox is a premium brand with a large marketing budget, which is added to the cost.
When Botox is truly not for you
Facts also dictate when botulinum toxin is contraindicated:
- Pregnancy and breastfeeding — there are no studies confirming safety, so the treatment is not performed.
- Neuromuscular diseases (myasthenia, ALS) — the toxin blocks neuromuscular transmission, which is already impaired in these conditions.
- Allergy to the ingredients of the preparation — rare, but possible.
- Infection at the planned injection site — treatment must come first.
- Unrealistic expectations — a good doctor will refuse the treatment if the goal cannot be achieved safely.
Summary — before you make a decision
Before you go for the treatment:
- Do your research using reliable sources (PubMed, dermatology society websites) — not TikTok.
- Check the doctor: medical licence (PWZ), specialisation, portfolio, and reviews.
- Consultation: a good doctor will refuse the treatment if they believe it is not necessary or if your expectations are unrealistic — this is a GOOD sign.
- Do not look for price bargains — with botulinum toxin, a low price is most often a compromise on quality or qualifications.
If you are already having Botox:
- Monitor the timing — the effect lasts for several months; do not return sooner than after 3 months.
- Do not increase the dose — if the effect lasts for a shorter time after several repetitions, consider changing the preparation, not the dose.
- Take photos of the effect in the same lighting after about 2 weeks — for an objective assessment rather than impressions.
J'ADORE INSTYTUT
At J'ADORE INSTYTUT, botulinum toxin is performed exclusively by aesthetic medicine doctors. This is because experience, not the preparation, makes the difference between a "frozen face" and a "natural effect". A pre-treatment consultation is mandatory and free of charge, as a good doctor listens first and injects later.
