Is It Possible/beneficial to Use Botox for Neck Wrinkles?

Botox does a reasonable, albeit temporary job on the vertical bands in the neck known as platysmal bands. It has very little effect on horizontal lines in the neck.

Botulinum toxin works best in active muscles of facial expression rather than static lines from chronic sun exposure or loss of elasticity. Therefore the muscles of the neck which animate with facial activity will see the best response to treatment. This consists primarily of the vertical neck bands ("turkey gobbler")

BOTOX is effective for the vertical neck cords. However it is not so good for the horizontal band likes. The issue is the vertical neck cords benefit form local treatment. However improving the horizontal bands is usually the result of muscular contraction plus skin creasing. However, a neck lift is a surgery that is very helpful for both conditions.

Botox can be used as an off-label indication for neck lines. I find that it does reduce the hanging vertical folds to some extent in many patients, but not comletely. It might be my technique, but I do not find it very helpful in horizontal neck bands for the majority of patients whom I have treated.

Botox can definitely be used to improve the appearance of the aging neck.  While not approved yet, it is very effective in treating what is called "platysmal bands", not true wrinkles. So what are platysmal bands?! Try saying an exaggerated and prolonged letter "E" out loud and look in the mirror... see those tense vertical strips along the front and side of your neck? Those are your platysmal bands! As we age, these become more prominent even at rest, without those intense expressions. Botox is a fantastic way to relax that neck muscle, making those bands much less apparent. While it improves the overall appearance of the neck, it is not directly addressing laxity/sagging, crepey skin, or horizontal lines and wrinkles. Depending on the severity of the bands, a good amount of Botox (usually about 5-10 units per band, and sometimes more) is often needed to have a dramatic effect.  See your board-certified provider to see if your neck could benefit!

Botox has beneficial effects in reducing appearance of platysma bands in the neck. This is an off label use but has been demonstrated to have efficacy. If the condition of the neck involves significant sagging or skin laxity, then neck lift would be the treatment of choice.

BOTOX® for cosmetic purposes in the neck is considered off-label. However, injection into platysma muscle bands may reduce the prominence of these bands but the effects are only temporary and the injections need to be repeated over and over again, usually at four to six month intervals. On the other hand, BOTOX® is of no help to skin wrinkles, sagging skin and fullness due to subcutaneous fat puffiness. Aging characteristics including sagging skin, prominent platysma muscle bands, subcutaneous fat prominence and wrinkles are best handled with a face/neck lift type procedure.
 

Botox can be used on the neck for improvement of the vertical bands. It is not FDA approved for this indication, but it has been used successfully off-label for years. Results are usually appreciable, but not as dramatic as when Botox is used on the face, particularly the glabella and crow's feet. Many wrinkles of the neck are due to skin laxity rather than muscle activity, and these will not be improved appreciably.
Smaller injection doses are used, usually 2-3 units per injection point, with 10-20 units total for the neck.

Neck skin that looks wrinkled because of platysma bands can be softened with Botox. More permanent improvements would be accomplished with a surgical neck lift.

Botox for neck wrinkles does work but is very expensive, because you use at least 100 units to get a good result. Remember it ONLY lasts 6 months if lucky.
From MIAMI Dr. B