Every week, patients ask me about something they read or saw that turned out to be wrong. Some of these myths are harmless. Some lead to bad decisions. All of them are worth clearing up calmly, with the science where the science is clear, and with honesty where it is not.
Here are the five I hear most often.
Myth 1: "Once you start Botox, you can never stop."
This is the most common myth I hear, and it is not true. There is no dependency, no withdrawal, no rebound effect.
If you stop getting Botox, the targeted muscles gradually return to their normal activity over the course of three to four months. Your face returns to its pre-treatment state. Not worse. Not faster-aging. Just back to where it was, with the normal continuation of aging from that point.
In fact, consistent use of neuromodulators over years can slow the formation of certain dynamic lines because the muscles have spent less time creating them. People who stop after years of use sometimes see lines re-form more slowly than they otherwise would have. That is the opposite of "you can never stop."
Myth 2: "Filler stretches your skin permanently."
This one has science on both sides, and the honest answer is "it depends, but mostly no."
Hyaluronic acid filler in moderate amounts, placed appropriately, does not produce lasting skin stretching. The product breaks down over months to years, and your tissues return to their previous state. This is the typical scenario.
Where the myth has some truth is at the extremes. Very large amounts of filler used over many years in the same area can affect tissue elasticity, particularly in areas like the lips where the underlying support structure is thin. This is one of the reasons we work conservatively, do not chase trends, and tell patients when they have had enough.
The right frame is this: conservative, well-placed filler does not stretch you out. Overfilling repeatedly can affect tissue over time. The choice of injector and the willingness to say no to "just a bit more" matters more than the product itself.
Myth 3: "Preventative Botox is necessary in your 20s."
It is not necessary. Most people in their twenties do not need Botox.
The "preventative Botox" idea sells well because it pairs anxiety about future aging with a concrete action you can take now. But the honest reality is that most twenty-somethings have skin that is doing fine. The most useful "preventative" things in your twenties are sunscreen, sleep, a retinoid by your late twenties, and not smoking. Those four things outperform any single injectable intervention.
If you have strong frown muscles that are already producing visible lines at rest, there might be a reasonable case for a small, conservative dose. But for most people in their twenties, the answer is "you are early, focus on the basics, come back when there is something to address."
A good injector tells you when you do not need treatment. That is part of the job.
Myth 4: "A licensed injector is a licensed injector. They are all the same."
They are not.
In Ontario, cosmetic injection is a controlled act under the Regulated Health Professions Act. It must be performed by a regulated health professional (typically a physician, dentist, registered nurse, registered practical nurse, or nurse practitioner) and, for non-physicians, under medical directive from an authorizing prescriber. That part is regulatory.
What it does not tell you about is the injector's training in injectable technique, their experience with the specific products and areas, their adverse-event management, or their judgment about who to treat and who to defer. Those things vary enormously and they are what determine your result.
How to actually evaluate an injector:
- Ask about their training specifically in injectable technique (cosmetic certifications, mentorship programs, continuing education)
- Ask how many years they have been doing the specific treatment you are considering
- Ask about their adverse-event protocols (what they do if something goes wrong, especially with HA filler)
- Look at consistent, recent, before-and-after work that suits the kind of result you want
- Pay attention to whether they ever say no to anything in their portfolio. Injectors who say yes to everything are a flag.
"Licensed" is the floor, not the standard.
Myth 5: "Cheap deals are equivalent."
The injectable price you see varies for real reasons. Three of them.
First, product cost. Health Canada approved products sold by manufacturers to clinics have a known wholesale price range. If you are seeing prices well below the wholesale cost of the product, something is off. Either the product is not what is being advertised, the volume is smaller than represented, or it has been sourced outside Canadian regulatory channels. None of those are situations you want to be in.
The cheapest injectable in the city is not a deal. It is a warning.
Second, the injector's experience. An injector who has been doing this for ten years with a thousand cases of experience charges differently than one in their first year. Both have a place in the industry. They are not equivalent.
Third, the practice's setting and protocols. A clinic that follows full sterilization and storage protocols, has emergency complication management available (including hyaluronidase for HA reversal), and runs proper medical documentation costs more to operate than one that does not. That cost is reflected in pricing.
Reasonable pricing varies. Suspiciously low pricing tells you something specific.
The thread through all five
Every myth on this list comes from somewhere. They are not random. They come from real experiences (someone who saw obvious filler and assumed all filler looks like that), incomplete information (a TikTok explaining preventative Botox without explaining who actually needs it), and marketing (cheap deals that bury what you are losing in exchange).
The best defense is a calm consultation with an injector who will tell you the truth, including when the truth is "this is not for you right now."