Is Botox an Option for Bands Showing After Necklift?

I had a necklift with platysmaplasty 4 mos ago. I think that maybe I had too much lipo just under chin, because when my head is tilted back, very small bands show and pull, and a larger band shows and creates a dent. What is the remedy for this? Is botox on these bands an option?

Doctor Answers 17

Botox for bands showing after necklift

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Botox is certainly an option to inject into the anterior platysmal bands to relax and soften them for 4-6 months.  This prevents the bands from regrowing together if they were transected at the time of the surgery.  

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews


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When a Platysmaplasty is performed the muscle bands in the neck are sutured together.  On occasion this may create a single band in the midline.  If this occurs Botox may help to alleviate their appearance until things are completely healed.  This is definitely worth a try.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.6 out of 5 stars 37 reviews

Neck bands following necklift surgery

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Your neck bands are likely due to several issues.  If they are prominent, Botox or Dysport is an excellent way to relax these neck bands as they are likely due to over active and prominent platysma muscles.  Aggressive liposuction of the neck,  especially in cases of removal of fat from below the platysma muscle during platysmaplasty and necklift can lead to a hollowed out appearance beneath the chin.  The platysma bands can become exceptionally prominent in this situation.  If your neck bands are particularly noticeable, then re approximation and even a small cut in the platyma muscles can remove the neck bands and create a smooth neck contour.  In any case, I would still wait several more months prior to any surgical intervention.

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

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Botox works for temporary improvement of neck bands after facelift

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Neck bands, which appear as two folds of skin beginning under the chin and extending toward the chest, are caused by a sagging muscle (called the platysma.) Botox can be helpful in improving those but only works for a few months. Plastic surgeons debate whether to sew the bands together when doing a facelift to prevent them from recurring; my preference is most often to do it.

Richard Baxter, MD
Seattle Plastic Surgeon
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Botox for neck bands

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Using botox to treat neck bands can work if the bands are appearing due to overactivity of the muscle but usually requires a reasonable dose of Botox. The small bands you are describing when you tilt your head back are not uncommon after a platysmaplasty if part of the muscle has been released or cut and may just be some scar tissue. At four months I might give it some more time to see if it improves on its own otherwise you can try some Botox to try and soften the appearance.

Platysmal Bands After a Necklift

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Liposuction in the neck may expose the platsymal muscles so that they will be apparent when you engage the muscles. The intervening fat between the muscle and skin was thinned during the liposuction so you can now see more of the action of the muscle through the skin.

At 4 months, you may see more healing. I have seen that suction-massage machines such as the Vela-Smooth or TriActive actually smooth the liposuction result and may cause an improvement to the neck area. Now is the time to consider the suction-massage treatments rather than wait until all the healing is complete. Also, Botox at the beginning of the suction-massage treatment puts the muscle at rest to give you the best result from the therapy.


Edward Szachowicz, MD, PhD
Minneapolis Facial Plastic Surgeon
4.6 out of 5 stars 14 reviews

Is Botox an Option for Bands Showing After Necklift?

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Maybe, but the bands may be the resuklt of how the Platysma muscle was sewn together, scarring or excess fat removal during the Neck Lift.  If that is the case, the Botox will not do much to improve the look of the bands and dents, IMHO.  Botox is easy enough to try, so why not do it and see what happens.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Plastysma bands

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Sometimes platysma bands are more prominent after liposuction of the neck as it is thinned out. Botox may help with those bands. AN exam is key to evaluate this.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Not all neck bands improve after Botox injections.

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Botox injections may improve the appearance of muscular neck bands, typically in patients under 50. Even in the best cases, Botox treatments for platysmal banding may be unpredictable.

If you're seeing irregular bands neck when you tilt your head back, this may be from scar tissue rather than muscle bands.

You should bring your concerns to your surgeon, or consider getting a second opinion from an experienced facelift surgeon.

I hope this is helpful for you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Platysmal bands that are present in the neck after facelift surgery can be improved with Botox injections into the Platysma

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muscle.  In the course of treating the neck in a facelift or necklift, fat is usually trimmed between the muscle and skin.  This can leave a "band" of the platysma muscle in the neck which is visible after the swelling from the surgery subsides.  I like to cut back the muscle in its mid portion in the neck to prevent the banding, and suture the remaining muscle on each side to itself to prevent this problem and give a smooth contour to the neck.  If there are visible bands like you are describing, Botox can be very helpful in softening the bands, although you will have to repeat the Botox injections as they wear off. 

Michael H. Rosenberg, MD
Mount Kisco Plastic 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.