Why did Botox not work on my platysmal muscle spasm? (photos)

This may be a combination of scarring and/banding.  I suggest you try more botox and venus legacy treatments to break apart the tissue and tighten it.  If this does not resolve in 3-6 months then you may need addtional surgery.  I suggest being evaluated as a second opinion.  Best, Dr. Emer.

It is an area that has inflammation and swelling after surgery.  I encourage patents to have a gentle facial and neck massage to encourage lymphatic drainage after facial procedures.

You may not have platysma spam. That is unlikely frankly.What you have is that you had liposuction of your neck and now you see the prominence of the platysma bands. The removal of the fat uncovered your platysma bands.Also liposuction of the neck has caused some irritation and trauma to the neck. That does not mean something wrongful occurred by your doctor. It means that structures adjacent to where surgery is done can get irritated.You should try higher dose of botox. If that does not work then the effective treatment for your bands and whole neck is a neck lift with platysma plication.