Ask a doctor

Botox or Fillers for Neck Rings and Bands?

After a neck lift, I am still not happy. I still have bands from the neck down, and also neck rings around my neck. Do I have more options? Will Botox or fillers help?

Doctor Answers 11

Forget the fillers

Deborah Kate,

Botox may help the bands that you describe by weakening the platysma muscle that forms the bands.  Fillers, in general, don't work well on the neck.  Weakening the platysma with Botox over a long period of time may eventually soften the rings.  Good luck!

Botox for Neck Rings

Thank you for the question.

Unfortunately, Botox is not effective in the treatment of transverse neck "rings". Fillers are probably your best bet but will be time consuming and expensive over time.

Best wishes.

Neck and botox

If  you had a neck lift and still have bands, you may get some benefit from Botox..  As for "neck rings" which I assume are the deep dermal creases of the neck, these probably will not get better with botox.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

Neck bands and rings

Deborah Kate:

Without an in-person evaluation I can only speculate about what you may be seeing, and I do not know what was done during your surgery (there are a variety of techniques used during facelift / necklift).

Vertical bands caused by the underlying platysma muscle are one of the primary issues treated by a facelift / necklift operation. Botox alone is much less effective, but may offer a little benefit in addition to your surgery. Clarify with your surgeon if your procedure included steps designed to correct to the muscle bands.

Horizontal skin wrinkles may correspond to the rings you notice. These typically do not go completely away after necklift. The ones lower in the neck are most likely to remain. Surgery improves skin tone and underlying structures, but your skin cover remains. Additional treatments for skin texture may be helpful. These include cosmeceuticals, intense pulsed light, non-ablative skin tightening, or laser resurfacing. These are often done as a series of smaller treatments, followed by periodic maintenance visits. Seek a physician experienced with non-surgical and minimally-invasive skin treatments (usually a board-certified dermatologist or plastic surgeon).

Sutton Graham II, MD
Greenville Plastic Surgeon
4.5 out of 5 stars 4 reviews

Very little improvement with both.

 The band problem would best be corrected with re-excision. Botox is short lived and gives little improvement and is more costly over time. Neck rings can be treated with fillers but once again is very costly over time.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

A consultation with your doctor is in order

I can't answer this because I don't know the nature of the bands, or the time since surgery. It would follow that the surgery would have taken care of the concerns. However if you are still within a few months from surgery, it may be a self limiting situation that would better respond to massage, moist heat, or even steroids. So an exam first, and frank discussion with the doctor who performed the neck liftt.

Botox Yes, Fillers No

This is an unfortunate complication with a facelift/necklift. In the operating room patients are relaxed and lying on there backs The neck muscles are sutured together in the midline and elevated and sutured by the ears. This is the standard approach to the neck and works most of the time. However, occasionally there are patients like you that have a very hypertrophied or strong neck muscle.

Botox will help relax this but is short lived and needs to be repeated. The surgical correction involves a back cut in the lower portion of the muscle which will relieve these bands

Perhaps another opinion would help.

Treatment of Neck Bands and Rings

Hi Deborah,

Aside from Botox and fillers, Fraxel repair treatment of the neck helps with the "neck rings" and tightens the lax bands. In most patients I am finding that 2 treatments separated by 4 to 6 months results in very nice tightening of the laxity in the neck.

Botox can be helpful but short lived and expensive, fillers have been disappointing, recently have heard of some physicians trying very dilute Sculptra to treat necks.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
5.0 out of 5 stars 29 reviews

You can have Botox for now

The treatment is either surgical in the form of revision of your neck lift or non surgical in the form of Botox.

Since you just had your surgery done, I would recommend Botox for now.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 17 reviews

Botox may well help.

To Deborah Kate,

Hi! It's too bad that you still have bands after a neck lift, but incomplete correction certainly can happen. Botox in fairly large doses (about 50 units, it's a big muscle) will definitely help, but it has to be repeated every 4 months. I am afraid the only alternative is a surgical revision.

Neck rings are not much improved by a neck lift, and are very hard to treat by any means. Botox in small doses sometimes helps here.

There is no role for fillers

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 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.