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Botox for Relaxing Neck Bands?

I've heard that Botox is being used to relax neck bands. Can you please share your opinions on this, the safety, effectiveness, expected cost, alternate treatments, etc.?

Doctor Answers 18

Botox can soften neck bands


Botox can indeed be used to soften neck bands as an off label use. I have found it to be very effective and safe. The cost depends on the size and extent of the bands. The alternative, surgical correction is, of course, more invasive, more costly, and requires a recovery. Good luck!

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Botox can relax neck bands, but not permanently

Neck bands develop as we age. There is a thin layer of muscle called the Platysma. The sole function of that muscle is to maintain contour of the neck by sharpening the neck angle below the chin. There is a strip of this muscle on either side of the front of your neck. As we age, the muscle loosens allowing the front edge of the muscle on either side to start hanging down creating neck bands.

Injecting Botox into these neck bands can relax the bands enough that they will relax and lie down, rather than protude outward. This is relatively simple treatment, but only lasts 4 months. The fee in my part of the country is $475. The best treatment is surgery. It's most easily done through an incision under the chin to get access to the edge of the muscle so that it can be tightened.

Sometimes, it's better to bite the bullet and have a neck lift with tightening the muscle, pulling the back edge up behind the ear. This is usually done as part of a neck/face lift. Sometimes, it requires both approaches to get the best result.

If you are considering surgery, please consult with a board certified plastic surgeon who has experience with these procedures.

Botox not very effective for most plastysmal bands

Botox relaxes muscles; it can not tighten loose muscle.

Although Botox has been proposed for neck bands, the efficacy is rather limited. If the neck muscle (a.k.a. platysma muscle) is loose under the chin, leading to platysmal banding, a necklift including platysmaplasty will be the most effective treatment. In this situation, Botox will likely be disappointing.

The only time I would consider Botox for the neck is if one is concerned with tight vertical muscle bands showing due to animation (i.e., laughing, grimacing etc.)

Although Botox is not FDA approved for platysmal banding, I would consider is relatively safe.

I hope this helps!

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.5 out of 5 stars 31 reviews

Botox is helpful for neck bands

Dear Iksugarman,

Neck cords are caused by laxity of the platysma muscle at the angle of the neck and laxity of skin. Botox can improve the appearance of these cords by relaxing the muscles bands that are producing the cords. Be aware that this treatment can use up a good amount of Botox (25 to 50 units) depending on the individual. Cost will depend very much on what your doctor charges for a unit of Botox. Longevity is about 4-5 months. Not everyone has a great response to Botox for the neck cords. The alternative treatment is a facelift so for many it is worth trying the Botox treatment.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 19 reviews

Botox for neck bands

Botox injections are effective at softening the neck bands (also known as platysmal bands). The treatment can also be combined with a “Nefertiti Treatment”, which will improve the definition of your jaw line and create a beautiful neck lift at the same time. The cost of your treatment depends on the number of units administered.

Suggest CO2 Fraxel for Correcting Neck Bands

These bands that have been there since your teenage years are not likely to be removed by Botox and it effects muscle activity. I would suggest the CO2 Fraxel Laser for this and I would not expect miracles. This is a difficult problem even to correct with surgery.

Botox and neck bands

Botox an be very effective in treating platysma bands. It will have no effect on skin laxity.  Usually I inject about 15-20 units for some bands, and may use more for multiple bands.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Botox for relaxing neck bands

As you may have gathered from the other posts, Botox is a good treatment for relaxing vertical neck bands.  50 units is usually adequate.  The total dose should not exceed 100 units and should be superficial to avoid complications including neck weakness and difficulty swallowing.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

Some side effects from Botox on neck reported

There is some retraction of the neck bands, making them look better in some, but not all individuals. When used in this off-label approach, it involves the same side effects as Botox when administered in facial regions such as brusing, but there is a risk that the neck muscles might be so relaxed that you could find it difficult to raise your head out of the hair salon’s shampoo sink, and a few cases of hoarseness have been reported.

Also, a very, very rare but serious side effect had been reported where a patient had difficulty swallowing, but this was not permanent. These worrisome side effects are possibly dose-related so reasonable number of units delivered to the area of the neck bands do not cause this to happen. Alternative treatment is a surgical neck lift. External radiofrequency devices may help minimally.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 33 reviews

Botox for Platysmal Bands

I routinely use Botox to treat platysmal neck bands.  I usually start with 40 to 60 units and dilute this in twice the normal amount of saline to provide uniform coverage.  It is safe and effective and cost much less than a traditional neck lift or platysmaplasty.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.