Risk of Being Unable to Swallow After Botox in the Neck?

Botox treatments in the neck when used for cosmetic indications are very safe when performed by a skilled knowledgeable physician. The results for softening the neck area called platysma bands can be excellent as well. I have been performing Botox treatments safely in this area for many years. When it was first proposed, the initial study reported a few patients with weakness in swallowing. However, they used over 100 units per treatment. I never use more than 60 units in any given visit for neck bands and lines, usually much less.
To reiterate the previous answer, it is off label for use in the neck. Use in this area by physicians is based on their skill and an explanation that given their experience, this medication is being used for purposes not specifically FDA approved, but helps their patients. There was a recent "Black Box" warning issued by the FDA for Botox. The vast majority of patients who had complications were given Botox for neurologic conditions such as muscular dystrophy and not cosmetic uses.

These injections need to be done by an experienced injector. Ideally, the individual is board certified by the American Board of Facial Plastic and Reconstructive surgery or Plastic and Reconstructive surgery. A clear knowledge of the anatomy of the neck is important in these cases. Also the dose chosen must be appropriate. When done correctly, the risk is low, however, many cases do not respond to botox and require surgical modification. Your surgeon should be able to differentiate and assess whether you are a good candidate or not.