I would like a second opinion: Platysmal Bands/How much Botox should be used?

It is impossible to know the concentration of Botox you received with the information you provided. We don’t know how it was diluted. You can aff at k the person who did your injections. More importantly however, you are wasting time and money with Botox injections expecting platysma bands to disappear. What you really need is a neck lift with plstysma muscle plication. Although this procedure is more invasive snd more expensive, it will give you a beautiful result which in the long run is less expensive because you will not be wasting time and money on repeated Botox injections. You already noted “ it did not work”

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

If your injector used 70 mls, it would be way over diluted, so I’m hoping you mean units. But even with 70 units, your platysmal bands are very strong. The proper solution should be surgical in the form of a platysmaplasty with a neck lift.

Treatment of neck bands are difficult- they may be due to overactive muscles or excess loose skin, results may vary.
Treatment options include non surgical skin tightening with RF microneedling or a surgical necklift.
find a trusted provider and arrange a consultation
best wishes

The number of Botox units really depends on the patient, I can inject anywhere from 10-70 units in the platysmal band area. If you’re not having results, you may also want to consider adding a skin tightening treatment, such as Ultherapy or Profound, as it may not solely be a muscular issue. At my practice, we have great results doing a combination of the two, if needed.

70 units of Botox is not too much to effectively treat several platysmal bands. Obviously, this becomes very expensive. That is why many people simply have an anterior neck lift and cut the bands. This minimally invasive procedure will provide significant improvement for 10 years.

Botox is mixed with saline into a composition of saline plus freeze dried Botulinum toxin.. the number of milliliters does not adequately quantify the strength of the dosage unless you know how much was dilutent . It is similar to having a cup of coffee with no sugar or one with 3 packs of sugar added . Both are considered a “ cup” of coffee but one is much stronger ( sweeter) than the other

The amount of solution injected does not necessarily tell you anything about how many units you have received. Botox can be diluted to different strengths for different applications. On average, I use about 16-20 units per band. The syringes used for these procedures typically only hold up to 1 mL. It is more likely that you received 0.7 mL of solution and depending on the dilution I would guess that was around 28 units with the most common dilution. Do keep in mind that the effects of Botox on the platysmal bands will take longer to become apparent compared to the treatment of facial muscles - often 2-3 weeks, so you still may see some softening of those bands. Appropriate patient selection is important, and the injections are most effective at improving bands that disappear at rest. Unfortunately, this treatment often is performed on patients who really require surgical intervention for the look they desire.