Botox and Potential Dangers of Platysmal Band Injections?

Typically platsyma bands benefit from 20 to 60 units of BOTOX.  My typically platysma band treatment is in the 20 unit range.  Diffusion of BOTOX is not the issue here.  Like any BOTOX service, a small percentage of sensitive patients can have a systemic effect from BOTOX treatment performed for platysma bands.  In my practice, the incidence of this sensitivity is about one case in 2500 treatments for a total treatment dose of 33 units of BOTOX.  That incidence is an estimate but it gives you an idea that it is rare but does occur.  With increasing dose, the incidence of systemic side effects that are well described elsewhere increases.  It is my opinion that botulinum toxin A sensitivity that results in the sensation of difficulty swallowing, shortness of breath, anxiety, etc is an absolute contraindication for having future cosmetic botulinum toxin treatments.  When botulinum treatment is performed for medical reasons, patients and their doctors need to individualize the response to these types of side effects in deciding if future botulinum toxin A treatment is worth the side effect.

It is reasonable to try a lower dose if you are concerned about this issue.  You might also discover that you can get a treatment result with less BOTOX and save yourself some money.

Hi Kap1,Thanks for your question. Botox is just like anything else. It always carries a risk just like driving in a car. It rare but it does happen. Neck bands or platysmal bands vary from patient to patient. The risk is about the same whether you do half a neck or not as the amount does not vary side by side but by the amount or number of bands. Usually is 1-2 units per 2cms and it depends on how long the band actually is. You can always under treat and return for more to minimize your risks. Seek a qualified botox specialist that is comfortable with neck anatomy! Good Luck,All the best,Carlos Mata MD, MBA, FACSBoard Certified Plastic Surgeon

Thank you for your question. Botox can be a very safe and effective way
in helping to soften the appearance of neck bands by relaxing the
muscles. I would recommend visiting with a board certified plastic
surgeon or dermatologist in your area to address your concern as it is
an advanced area to treat. And in addition, there may be alternatives
that can be used as a standalone or in conjunction with Botox to provide
an even more effective treatment.Splitting the treatment as you suggested would be a very reasonable strategy.

Your question makes good scientific sense, but the toxicity has not been studied so well as to provide us answers to give you.  If there were a very high number of units needed (that should not be the case) then you could consider to have one side done and a week later to do the other so that the number of units is limited per session, but this is just not done on a practical basis. Most patients will see board certified dermatologists or plastic surgeons and have average number of units injected. It may not be the total amount of units that was the cause for the few reported cases of complications, but possibly inadvertent entry of Botox into a blood vessel. In order to minimize complications, only 2 units are injected per site and the sites are spread apart to allow for diffusion from each injection.

Please make sure that you are being injected by a board certified and qualified plastic surgeon with extensive experience in Botox injections.  Doses vary from patient to patient and desired treatment effect, so without seeing  you in person, it is impossible to give you an absolute number of units.  However Botox treatment of platysmal bands can be very safe and effective.

 

Good Luck.