Neck cords - stringy neck. Any suggestions for treatment options? (Photo)

Question

I'm a 39 yo fit, slim woman with unfortunately stringy neck cords. Any suggestions for treatment options?

Toby Mayer, MD · Answer

Treatment for early neck bands with very thin skin? You have so little fat in your neck that the muscle and bands show through readily. The treatment for improvement but not elimination would be a neck lift. See a very experienced surgeon who does not give you a problem worse than the one that you have. Make sure he does natural looking surgery.

Jonathan Kulbersh, MD · Answer

Platysmal banding can occur in the neck and is very prominent in some women, especially those with thinner necks as there is less fat to disguise it. The first line of treatment for these bands is usually Botox, administered by a very skilled surgeon as Botox to the neck is a delicate procedure that needs to be done with the utmost care and precision. Botox works to relax the muscles and soften the bands, leading to a smoother looking neck. If Botox is too temporary for you or is ineffective, you could consider a surgical neck lift, which will give longer lasting, more permanent results. I hope this helps.

Leonard Lu, MD · Answer

Thank you for your question. Botox can help relax platysmal bands. The treatment results typically lasts 3-4 months and should be performed by an experienced injector. Dr. Leonard Lu

David W. Rodwell III, MD · Answer

You are seeing bands of the platysma muscles.  Some people have more banding than others, but in your case it shows much more because you have such a think neck.  Usually that's considered a good thing, but in your case there is less fat under the skin to hide the muscle bands.Botox is a good first step to relax the muscle in that area.  It is worth a try to see how much improvement you get.  The problem is that Botox for neck bands is temporary, and the cost really adds up over time.  A surgical procedure is your long-lasting and more thorough option, but at 39 you may not be ready or that yet.  It would take a better in person exam and getting to know you and your goals before making any decisions about suggesting surgery.

Christian Subbio, MD · Answer

The bending on your neck is more moderate than simply mild.  As such, Botox may offer some softening, but may not be the home-run you are looking for.  As well, the doses can be hefty and need repeating every three or four months.  The cost over the years will be substantial, in the thousands.  So, it can't hurt to try Botox first to see how effective it is to help you decide whether or not this is the long-term solution for you.  However, I suspect a more adequate solution will be surgical.  Yes, this means increased cost, at least initially, but over time this will balance out quickly.  And, the results are much more dramatic.  Discussed this further with a board certified plastic surgeon.Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Brian K. Machida, MD, FACS · Answer

Probably Botox is your first line of treatment as it is the least invasive and I can't tell how the rest of your face is. If you are not happy with that, then surgery is your next step.

T. Gerald O`Daniel, MD, FACS · Answer

The bands that are most notable on contraction with good skin quality will respond To injection of a neuromodulat or such as Dysport or Botox.

Todd C. Miller, MD · Answer

Hi Allesin, the bands in your neck are created by the platysma muscle. As we age, our skin loses elasticity and the muscle underneath the skin begins to sag. Your situation is a bit more exaggerated because you appear to have a very slender neck. You have a number of options. The least invasive option would be Botox. This can help relax the muscles and make them less prominent. Another option would be ultherapy. This uses ultrasonic energy to tighten the muscles. The most thorough option for you would be a neck lift procedure in order to tighten the muscle.Consult with an experienced facial plastic surgeon who can give you options.

Gustavo A. Diaz, MD · Answer

Botox will be your best option instead of surgery for your problem.Hope this helps,Dr. Gus Diaz

Ben Talei, MD · Answer

The easiest way to start is by trying Botox to relax the pull of the bands.   The next step up is to perform heating tightening therapies Like thermi RF or Syneron profound.    Some surgeons might experiment with performing a platysmaplasty followed by RF tightening if needed.  The most effective and long lasting is a vertical deep plane neck lift which gives the most dramatic and durable outcome but requires a surgery

Neck cords - stringy neck. Any suggestions for treatment options? (Photo)

Answers (13)

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