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Will Botox Get Rid of Neck Bands?

Hello, I have had "necklace bands" or those horizontal lines that go all the way around my neck since childhood. Now they have deepened and look worse than ever.

I have a nice slim neck, but the lines are very unattractive. I have heard both yay and nay with regards to botox for necklace lines. What's the verdict? Also, are there other treatments that would work better such as laser or peels? Please help, I am desperate to get rid of these bands!

Doctor Answers (22)

Botox for neck bands

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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.  

Botox and Neck Bands

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The Botox® neck lift refers to the use of an off-label FDA usage of a muscle Toxin like Botox to relax Platysmal bands (midline muscular bands (Platysmal bands). It is not a true neck lift. In the right hands it is effective in temporarily relaxing these muscle bands which causes the skin to be less stretched in appearance. The treatment is temporary and needs to be repeated every 3-4 months for most.

Risks include if injected too deeply or using too much - swallowing difficulties, or head movement from weak neck muscles.

Lasers like the BBL by Sciton do a reasonable job at tightening and smoothing the skin when done as a series.
Ultherapy also helps some, thermage less so in my experience

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 55 reviews

Botox and neck bands - Los Angeles

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Botox can certainly work well in targetted areas of neck bands and neck cords formed by overactive platysma muscles. Raffy Karamanoukian Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 54 reviews

Botox for Neck Rings

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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.

Horizontal neck bands may not respond well to any treatment but Ulthera, Theramge and Botox may help

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Vertical neck bands may respond partially with Botox but I have not been successful to minimize horizontal neck bands with Botox although I have heard that some physicians claimed in the past that this can help.  Some, not all, patients who are undering Ultherapy have noticed improvement in the horizontal neck bands.  There have been reports of Thermage helping and even Fraxel laser, but I would be doubtful that the horizontal bands would improve much.

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

Vertical bands are very responsive to neuromodulators such as BOTOX

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Vertical bands are very responsive to neuromodulators such as BOTOX, Dysport, or Xeomin.  The necklace horizontal bands can respond to some degree, but do not respond well in general.  And, all of the neck treatments with BOTOX or other neuromodulators tend to require a lot of product and therefore, are not very cost effective.  The neck is a very difficult area to treat.  Usually lasers will work best.  But, if the neck bands are very deep, it may require several treatments.  Sometimes doing an injectable filler, such as Juvederm, may be helpful (depending on the depth of the lines), but you have to be careful (even when doing lasers) to not go very deeply.

Botox and "Necklace" lines

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Necklace lines are not dynamic--caused by muscle movement--therefore neuromodulators are not the correct treatment. They usually are a combination of genetic factors and photodamage choose your parents more carefully next time  :)

Neuromodulators work very well for vertical lines caused by the platysma muscles.

The best improvement I have seen with necklace lines is when a patient is consistent with good corrective skin Obagi Nu Derm...they consistently protect from sun exposure, and they undergo either one or two TCA chemical peels or ActiveFx/Deep Fx laser skin resurfacing.

Reginald Rice, MD
Folsom Facial Plastic Surgeon
4.0 out of 5 stars 4 reviews

Horizontal Neck Lines

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Horizontal neck lines are a rather vexing problem and aren't treated particularly well be any individual therapy.  Botox is not something I would recommnend for this particular issue.  A series of low energy fractionated CO2 laser treatments can be helpful, but will not eliminate the problem.  The same can be said for fillers.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 43 reviews

Botox for Neck Bands

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These neck 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 plus filler for neck lines

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Botox is often used for the vertical lines (platysmal bands) in the neck, but are not very helpful for the horizontal lines.  The horizontal lines can be treated with a very small amount of filler (Restylane, Juvederm) injected directly under the lines (emphasis on small amount so the filler doesn't make matters worse).  The effect can often be enhanced by injecting Botox to relax the underlying muscles.

Alison Stallings, MD
Tarrytown Dermatologic Surgeon

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.