Botox made vertical platysmal bands worse. Will it resolve? (photo)

I had 2 small vertical platysmal bands underneath my chin. Botox was injected by my cosmetic dermatologist -days after the bands became exaggerated. Now they are noticeable looking at me head on whereas before I would have to look upwards to see them. I went back and he injected more Botox directly into the bands and surrounding areas. It's been over a month . I'm 37. I want to know if my neck will return to its pre-Botox state after it wears off? Could this have caused permanent damage? .

Doctor Answers 9

Platysmal bands

Thank you for your question houston1979. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression. Botox can be placed in the platysma muscle on the neck to treat neck bands. The bands normally extend from the jawline down to the collar bone. If the lower area only was treated, the upper area may contract more forcefully in order to compensate. This is easily treated by placing some Botox in the upper area. Please consult with a doctor for specific recommendations. Good luck!


Encino Physician
5.0 out of 5 stars 1 review

Botox for vertical platysmal bands

The Botox injected into your vertical platysma bands will wear off in ~3 months. There will be no permanent damage. A definitive solution for these bands would be a plastysmaplasty, either by sewing the edges together or dividing the edge of the muscle. 

All the best,

Dr. Brace 

Matthew Brace, MD
Ontario Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Botox results

Sorry to hear about your experience. The Botox will not cause any permanent damage. The results will wear off in 3-4 months. I'm not sure exactly what happened here, but I find that Botox works well for vertical neck bands caused by platysmal contraction. 

Botox made vertical platysmal bands worse. Will it resolve?

Absolutely - BoTox or other neurotoxins are temporary in terms of their effect. This is what make people that are happy with their result unhappy in that they need to have more neurotoxin injected. 

Perhaps there was a miscommunication originally? 

Michael Kulick, MD, DDS
San Francisco Plastic Surgeon
4.1 out of 5 stars 10 reviews

Vertical Bands on Neck

This will resolve after 3-4 months if botox was injected.  Ultherapy/Thermage may help get this better.  Thread lifts can give some subtle improvement as well.  You can do weekly venus legacy or exilis to give improvement.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 167 reviews

Problems after Botox

So sorry to hear about your problems. I'm not a huge fan of Botox for platysmal bands, but it does seem to help some patients. You, unfortunately, seem to be a patient that it doesn't. The good news is that Botox can never cause a permanent problem. The issues you are having will resolve as the Botox effect disappears. Unfortunately, you will still have your original problem with the bands. Consider seeing a facial plastic surgeon so all your options can be discussed.

Andrew Campbell, M.D.

Facial Rejuvenation Specialist

Quintessa Aesthetic Centers


Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Botox Made Vertical Neck Bands Worse

Before and After pictures would have been useful for a side by side comparison. Botox can work very well for vertical platysmal bands in the appropriate candidates. The effects will wear off after 3-4 months and everything should go back to how it was before treatment. See an expert next time. Best wishes.

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 9 reviews

Botox made vertical platysmal bands worse. Will it resolve?

Hello Houston 1979,

Botox usually helps to soften the platysmal bands.  I am sorry to hear it made yours appear worse.  The good news is, the results of Botox are only temporary.  It will last for about 3 months, so you are 1/3 of the way there.  I'd recommend you consult with a facial plastic surgeon to learn about the various options to improve your neck.

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Botox and platysmal bands

Botox can improve platysmal bands. However the results you are showing are atypical. Botox is not permanent. Consider a neck lift or mini-facelift to get a more permanent result. 

Jose E. Barrera, MD, FACS
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 40 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.