Can Botox or fillers help the look of neck bands temporarily? (Photos)

Question

Hi, I’m 47 years old and very unhappy with my neck. I want to put off a lower face lift till I am 50. Would Botox or fillers help the look of my neck temporarily or is their any other procedure that would help that does not involve surgery? I’m not looking for perfection, I just want to not look older than I am and I feel my neck is the only area that is aging badly.

Jonathan Kulbersh, MD · Answer

You have a few options. Try Botox to soften your platysmal bands and chemical peels to improve the quality of your skin and, one hopes, restore a bit of elasticity. Kybella or neck liposuction may be good options for defining the chin and jawline. I hope this helps.

Alexander Rivkin, MD · Answer

Hello and thank you for your question.  Botox can certainly help in the platysmal bands that are seen in your photos.  With careful injections you can see an improvement that can last 3-4 months.  The laxity in your skin, however, can be improved with treatments such as Thermage, Ulthera, or Profound.  All three are used to promote collagen in the skin's deeper layers which in turn tightens and lifts.  Being that these modalities promote your own natural collagen production, they will generally last a few years, until the natural aging process takes over once again.  I think these are great options before undergoing your surgery in a few years.  Best of luck!

Ron Shelton, MD · Answer

In no way does Botox make neck bands disappear compared with a surgical outcome but for those patients who are not ready for a necklift, I have found that just 1-2 units of Botox scattered along the length of the hanging platysmal muscle bands of the anterior neck soften their sharp angle making the neck rejuvenated, looking younger and tighter. This off-label use of Botox has been known for many years. I find Botox to be more effective in improving these neck bands than external energy devices such as laser, Ultherapy, Thermage, CoolSculpting or SculpSure (although they are helpful in tightening the skin and reducing fat).The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  Based on your pictures it appears that you have some mild platysmal banding which can be treated with Botox to soften their appearance.  I would see an ASPS board certified plastic surgeon in consultation to discuss.

Gary Linkov, MD · Answer

There are alternatives to the traditional facelift/neck lift. These include radiofrequency tightening technology, thread lifting, submental platysmaplasty, and occasionally filler and neurotoxin. The non-surgical options are less invasive but offer a less dramatic outcome and often are shorter lasting. In your case, the prominent platysma bands can be treated with botox. It is worth a try given your desire to wait on any more invasive treatment. Make sure to seek out the care of a board certified plastic surgeon with extensive experience in treating the aging face. Find someone you connect with who will listen to your concerns and provide you with a framework for what is possible.
Gary Linkov, MD
Facial Plastic Surgeon in Manhattan

Alex Eshaghian, MD, PhD · Answer

Thank you for your question and for sharing your photographs Trishalish. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.Although Botox is most commonly used in the upper face, it can also be used in various areas in the lower face. Botox can be placed just under the jawline in what is called the Nefertiti lift to relax the platysma muscle which pulls down on the lower face, thereby improving jawline definition. When placed lower in the neck Botox can address vertical neck bands. Approximately 10 units are used below each jaw and in each band.If I had a patient who looked like the person in these photographs I would say she is a good candidate for treatment of her vertical neck bands with Botox.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
  
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
  
Please consult with a doctor for specific recommendations. Good luck!

Monika Soni, MD · Answer

Thank you for your  question.  Based on your pictures it appears that you have some mild platysmal banding which can be treated with Botox to soften their appearance.  I would see an ASPS board certified plastic surgeon in consultation to discuss.

Dean P. Kane, MD, FACS · Answer

Dear Trishalish:

Thanks for sharing your photos. They are helpful.

Without gritting your teeth it is difficult to assess whether the bands are skin folds or the medial edge of the platysma muscle (ie., “the” bands).

·         Botox will weaken the edge of the muscle band softening their appearance. The caveat is that weakening the muscle also allows the tissues under the jawline to sag.

·         Another option is to use the minimally invasive Silhouette InstaLift suspension sutures to pull the bands together and lift the neck.

·         I have used Sculptra for neck lines but Sculptra nor fillers will not provide any enhancement of your neck.I hope you will consult with a talented, Board Certified Plastic Surgeon who will properly evaluate you and your desires and offer the best treatment to meet your expectations. All the best!

Michael Hall, MD · Answer

Botox is a great option to treat prominent platysmal banding.  While a surgical procedure such as a lower facelift or neck lift would give you the most dramatic results, neuromodulator (Botox, Xeomin, etc.) treatment will soften your prominent neck bands.  This may provide the improvement you are looking for before committing to a surgery in a few years.  If your issue is due to general skin laxity and not necessarily the underlying muscle activity, Botox will not provide a significant improvement.  There are other non surgical options that can tighten the lower neck but I find that patients find the most satisfaction with traditional surgical procedures.  I recommend you seek a consultation with facial plastic surgeon who can examine you in person and go over different treatment options to determine what is best for you.  Good luck!

Camille Cash, MD · Answer

There are many options you can explore to help with the lower face/neck area.  Botox is helpful in softening the look of neck bands.  Other options include Kybella to address the chin area or Sillhouette InstaLift to give you beautiful lifting results that last up to 18 months.  See an expert in your area for a consultation to learn what is best for you.

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