As we age, the neck often reveals some of the earliest and most noticeable signs of aging. Horizontal lines (also known as necklace lines or tech neck), skin laxity, and vertical tendon-appearing bands can develop, creating an aged appearance that many find frustrating. Among these concerns, platysmal bands—those vertical cords running down the neck—are particularly distressing. They can create a skeletal appearance for some and a “turkey neck” effect for others. Fortunately, the recent FDA approval of Botox for treating platysma bands, also known as neck bands, offers a game-changing, non-invasive solution for neck rejuvenation.
Understanding Platysmal Bands and Their Impact
The platysma muscle is a thin, sheet-like muscle that spans from the collarbone to the lower face and jawline. It extends along the length of the neck and attaches to multiple facial features, including the skin of the cheek, the muscles at the corner of the mouth, and the front part of the jawbone. It is the most superficial muscle in the face.
When the platysma contracts, it lifts the neck tissue while pulling down the facial tissues, making it one of the primary depressor muscles of the face. We can achieve a subtle lifting effect in the cheeks and jawline by strategically relaxing this muscle with neuromodulators.
What Causes Platysmal Bands?
Platysmal bands are areas where the platysma muscle fibers have bunched together into a band rather than uniformly spreading out like a sheet.
While the exact cause is debated, the most widely accepted theory suggests that, over time, the platysma muscle thins and its central connections weaken. This results in the muscle fibers clustering into distinct bands rather than maintaining an even distribution across the neck. As a result, these vertical bands become more visible, especially when the muscle is engaged—such as when pronouncing “eeee” or when smiling broadly.
These bands become more pronounced with age, contributing to the perception of sagging neck skin and an overall aged look.
Treatment Options for Neck Rejuvenation
Many patients seek treatment for various age-related changes in neck tissue. Flexible dermal fillers like Revance’s Redensity or SkinMedica’s Skinvive can significantly improve horizontal neck lines. Biostimulators like Sculptra can help increase collagen and support the neck anatomy, further reducing the appearance of crepey skin on the neck. A surgical neck lift is also an option to improve the appearance of the neck, and if there is significant tissue laxity, it may be the only practical option.
It is important to note that neuromodulators, such as Botox, have been proven effective in reducing the appearance of platysmal bands. Botox was recently FDA-approved for this indication. Neuromodulators work by impeding the nerve signal for muscle contraction. This relaxes the muscle and reduces vertical neck bands.
The Treatment Process
A Botox treatment for platysmal bands is quick and relatively comfortable. Here’s what to expect during the procedure:
- Cleansing the Skin – The treatment area is first cleaned with an alcohol solution to ensure a sterile environment.
- Precise Injections – Using a fine needle, small amounts of Botox are injected into four to five points along each prominent band below the jawline. This relaxes the muscle, softening the appearance of vertical band.
- Enhancing Jawline Definition – In some cases, Botox can also be injected just above and below the jawline to create a subtle lifting effect, enhancing cheek definition and improving the overall contour of the lower face.
Results & Longevity
- When will I see results? Most patients start noticing improvement within a few days, with full effects visible around 10–14 days post-treatment.
- How long do results last? Typically, the smoothing effect lasts about 3–4 months before a touch-up is needed.
- Is it safe? Yes! Botox for platysmal bands is an FDA-approved treatment when administered at the recommended dosage by a qualified injector.
Pros & Cons of Botox for Platysmal Bands
Pros:
✔ Non-Surgical Alternative to a Neck Lift – Botox provides a minimally invasive way to soften vertical neck bands without the need for surgery or extensive downtime.
✔ Quick & Convenient – The treatment takes just 10–15 minutes and requires little to no recovery time, making it easy to fit into a busy schedule.
✔ Smoother, More Youthful Appearance – By relaxing the platysma muscle, Botox can create a more refined and elegant neck contour.
✔ Enhances Jawline Definition – When injected above the jawline, Botox can subtly lift the lower face, complementing the effects of jawline filler or skin-tightening treatments.
✔ Customizable & Complementary – Botox can be combined with other neck rejuvenation treatments like dermal fillers or biostimulators to target horizontal neck lines, crepey skin, and volume loss for a more comprehensive rejuvenation.
✔ Safe When Performed by an Experienced Injector – When properly administered, Botox for neck bands is a well-tolerated and FDA-approved treatment.
Cons:
⚠ Temporary Results Require Maintenance – Botox typically lasts 3–4 months, so regular treatments are needed to maintain a smooth neck appearance.
⚠ Does Not Address Significant Skin Laxity – If loose or sagging skin is the primary concern, additional treatments such as skin tightening procedures or a surgical neck lift may be more effective.
⚠ Potential Side Effects – While rare, improper injection technique can lead to temporary side effects such as mild neck weakness, difficulty swallowing, or an unnatural appearance. This underscores the importance of choosing a skilled injector.
⚠ Limited Impact on Deep Wrinkles or Fat Deposits – Botox works by relaxing muscle contractions, but it does not address deep-set horizontal wrinkles, which may require alternative treatments like fillers.
Optimal Age Range for Treatment
Botox for platysmal bands is most effective for individuals with mild to moderate neck banding and good skin elasticity. While there is no strict age limit, the ideal candidates typically fall within the following groups:
Ages 30–40s: Early intervention can help prevent deepening platysmal bands and maintain a smooth, youthful neck over time. Many younger patients use Botox proactively to delay visible aging signs.
Ages 45–65: The most common age range for treatment, as natural collagen loss and muscle contraction make vertical neck bands more prominent. Botox can provide a noticeable improvement in smoothing the neck and enhancing jawline definition.
Ages 65+ or Those with Significant Skin Laxity: While Botox can help with dynamic muscle-related banding, it does not tighten loose skin. Patients with excess sagging may benefit from complementary treatments such as biostimulators or even a surgical neck lift for optimal results.
Conclusion
Botox for platysmal bands is a safe, effective, and FDA-approved treatment that can help you achieve a more youthful, refined neck contour without surgery. However, the best results come from a customized treatment plan tailored to your specific anatomy and aesthetic goals. At Aluma Aesthetic Medicine, we take an individualized approach to neck rejuvenation, ensuring natural-looking outcomes that complement your overall facial aesthetics. Ready to see if this treatment is right for you? Book a consultation with us today, and let’s create a plan to help you look and feel your best!
