Is Botox the only non surgical procedure for platysma bands? (photo)

Your photos show very prominent platysma muscle bands in your neck.  Bands can be passive (loose and saggy), active ( low but firmer with more muscle tone), or a combination of both.  Treatments differ depending on the type of bands you have and the degree of loose neck skin.  Botox and its alternatives (Xeomin or Dysport) can relax muscle tone and therebye improve the appearance of "active" muscle bands.  However, the effect only lasts about 4-5 months, and has some possible side effects.  On the other hand, surgery to tighten, lift and partially divide the platysma muscle bands, along with skin tightening (essentially a necklift) is generally considered the most successful and longest lasting treatment for neck bands.  Other than the neuromodulators, such as Botox, I don't know of any other worthwhile non-surgical treatment for neck muscle bands.  Interestingly, if you don't have any significant loose neck skin, you could just have the muscles tightened through a small incision under your chin using numbing medicine, local anesthesia, in a doctor's office.  You should first see an experienced plastic surgeon for a thorough analysis of your neck.

It is not clear to me from the question whether the term Botox was intended to cover all neuromodulators currently available (i.e. Dysport and Xeomin). In my nearly a quarter of a century using neuromodulators I have sometimes found that when one neuromodulator has not proven effective or sufficiently effective, substituting another, such as Xeomin, may prove to be.Moreover, occasionally the fault for lack of effect in treating platysmal banding may be the wrong technique or insufficient concentration or amounts of the neuromodulator injected. For best results I do not simply recommend the injection of the bands themselves, but a combination with a neuromodulator injection technique known as the "Nefertiti Lift,"  which, when performed properly, can result in additional, secondary upward pull on the neck. Finally, a technique known as The Nonsurgical 3D Vectoring Necklift, which uses volumizing fillers to provide "deep support volumetry" in order to achieve lifting and projection, in properly selected individuals, can yield quite gratifying results, especially when combined with neuromodulators. I have been routinely performing this technique for nearly a decade. The technique takes only about fifteen minutes to perform and the results are immediate and typically quite gratifying often engendering an immediate "Wow!" effect.I was one of the first to try threadlifting in the U.S. when it was introduced and approved in the early 2000s. I gave it up after only two years, since the procedure was expensive, minimally invasive, engendered down time, and mostly because the results did not last at best more than 8-12 months.I am not much of a fan of expensive treatments with fraxels, radiofrequency, and ultrasound devices, which often yield unimpressive, subtle and inconsistent results and are proving themselves to be far more device manufacturer supported marketing hype than hard science.For more information on the above techniques, check out the archives of RealSelf.com.Consultation with a board certifed aesthetician physician with experience and expertise in nonsurgical neck rejuvenation is a must. Insist upon seeing his/her before and after photos of  nonsurgical neck rejuvenation in persons within your particular degree of banding and laxity.