Botox on Platysma Bands Usually Successful in Younger Patients?

I know Botox results are injector dependent. That being said, is the off-label use of Botox to platysma bands a bad idea, no matter what, or is it usually sucessful when done on "younger" people that have very mild flaccidity? Thanks for your time!

Doctor Answers 13

Botox for platysmal bands

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Botox is great for the neck platysmal bands, no matter what your age. Keep in mind, however, that the results are not as good as a formal necklift. Try the botox and see if you like the results. They'll last for about 3 months, but a necklift can last 10 years! Check out some before and after photos to see which results you like the best. Good luck!

Off label use of Botox for platysma muscle

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This tends to work best in patients with hyperactive platysma muscles creating vertical bands regardless of age. Generally Botox is advised for patients under the age of 65. The "good or bad" idea of its use depends on how it is applied.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Botox for Neck and jowls

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I have seen some dramatic results with the use of Botox and Dysport for platysmal neck bands. Younger patients will require less Botox and may have more dramatic results. I have also seen some good to excellent results in older patients. Botox and Dysport can also be used to inject the jowls and get a nice jowl lift as well.

Janet M. Neigel, MD
Florham Park Oculoplastic Surgeon
4.6 out of 5 stars 21 reviews

BOTOX works well for muscle bands in the neck.

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Younger patients, under 55, that have prominent platysma bands in their neck will usually benefit from BOTOX Cosmetic treatments. The results are a bit unpredictable, and younger patients do respond best.

The ideal candidate is someone with visible neck bands that are present when they are speaking. So I'll observe for this during the initial consultation, and suggest it when appropriate. These folks that are good candidates, typically come back for more after the effect dissipates over 4 months.

I hope this helps, and best regards.

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

Botox Works for Platysma Bands

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Botox works well for hyperactive bands formed by an active platysma muscle but its not going to work for flaccid skin which usually happens from loss of collagen and elasticity. For loose skin, Sculptra injections might be better.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Botox works well for bands but not the horizontal lines in the neck

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It works well for platysma bands in younger patients. It doesn't work for the horizontal lines in the neck also related to the platysma but more a function of skin elasticity and volume. It of course doesn't help with fat or lax skin. If the skin is relatively elastic in a younger person the softening of the bands can create a better neck contour and recruit some added skin into the area.

Wayne F. Larrabee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Botox is very effective for a non-surgical method

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Dear Beach,

In posing the question, you have the right idea. BOTOX and also Dysport are effective at softening the bands. This can be a great option for a small neck cord. Treatment effect typically lasts for many months.

However, when the effect is not strong enough, surgery becomes a consideration. The neck cords that are modest but not sufficiently improved by BOTOX or Dysport can be amenable to an isolated platysmaplasty. This is a procedure done in the office under local anesthesia. The muscle cords are trimmed and then sew back together. This can also be combined with lower face and neck liposuction for results that can rival a facelift. For larger neck cords, a lower face and neck lift is the answer. This surgery continues to be the most powerful surgery for improving facial appearance.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Botox works for Platysmal Banding

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Yes, Botox works extremely well for platysmal banding when there is not excess loose skin. When loose skin is present, the Botox will relax the platysma muscle fibers, but the lax skin is still visible and unsightly. If this is the case, a necklift would be recommended to rejuvenate the neck rather than Botox. With the help of your doctor, you should be able to quickly decide the best option for your neck. Good luck!

Randolph Capone, MD, FACS
Baltimore Facial Plastic Surgeon
4.7 out of 5 stars 51 reviews

Botox is great for platysma bands.

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1)  We mainly treat people under 40 with Botox for platysma bands, because they are too young to have surgery, and the results can be dramatic.

2)  The platysma is a big muscle, and you need a lot of Botox (injected superficially for safety) to get a good long result.  We often use 50 units.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Botox for Neck Banding

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In younger patients with good skin tone and minimal banding then yes Botox does work. In older patients who have the bands prominent all the time, they are not the best candidate for botox.

You would ideally want the bands to not be there in repose and then present with animation. That is what BOTOX works best on.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

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.