Treatment for Neck Bands when Botox and Neck Lift Aren't Options?

Platysmal bands occur because of a diastasis of the midline platysmal muscle and a laxity of the submental fat. Serious thought should be placed into performing the gold standard for correction, neck lift and platysmal plication, rather than other non-invasive procedures that do not address the muscle.
In my practice, I adhere to surgical guidelines to correct problems that are surgical in nature. Performing lesser treatments lead to dissatisfied results.

It would be best to consult with a board-certified surgeon in-person as you may have more than one option. The presence of banding down the front of the #neck, and, amount of excess skin and condition of your skin are among some factors which determine if you are a #candidate for #rejuvenating the neck. Chin deficiency with the neck and jawline are also taken into consideration. A weak #chin implies a lack of chin support for the skin along the neck line. As a stand-alone procedure, chin augmentation can be performed in the office under local #anesthesia. For individuals with signs of aging in the neck, a chin implant added to one of the recommended procedures above, will provide optimal results.
Patients who desire facial rejuvenation that is affordable, quick, and effective should also consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift, individualized for each patient, that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.
A board certified plastic surgeon should evaluate both your anatomical features and aesthetic goals to suggest which procedure best suits your needs. In some cases there may be more than one option to choose from. If you are not a candidate at the time of your #consultation, your board surgeon can recommend non-surgical alternatives to address your concern. 

                  Several
factors contribute to the development of platysmal bands. These include
separation of the paired platysma muscles, weakness and laxity of these muscles
and loose overlying skin. Correction of this problem requires that all of these
components be addressed.

                  It’s
virtually impossible to make a recommendation without a physical exam or
pictures. In the majority of patients a neck lift with plication of the paired
platysma muscles will be necessary to correct this problem.

                  It’s
important to consult a board certified plastic surgeon with experience in this
area. This surgeon should be able to formulate a treatment plan to address your
problem. 

Neck bands are usually a combination of three things:
1. Loose skin of the face and neck
2. Loose muscles
3. Loss of volume of the face
The reason you did not have success with minimally invasive tightening treatments and Botox to the neck muscles lies in the weaknessof those treatments.
Botox relaxes muscles. It does not tighten them.
Radiofrequency treatments or fractionated lasers offer only a very small amount of permanent tightening, much less than what is typically bothering patients.
With proper medical clearance and optimization of the medical status, most patients can have a facelift, even if it performed under light sedation under the watchful eye of a board certified anesthetsiologist.
The difference between a neck-only lift performed from behind the ear and a facelift is not that much in experienced hands. A facelift/necklift with platysmal tightening is from your description the right procedure without respect to medical issues.
An experienced surgeon will perform the procedure quickly and with minimal blood loss. A novice will take a great deal of time and incur a large blood loss, a physiologic burden the patient must carry.
If several experienced surgeons do not believe you are a candidate for surgery for medical reasons, this is something to listen to. While you will undoubtedly find somebody to perform surgery on you who does not have concerns about your underlying medical conditions, this is obviously to be avoided.
You may have a decent result from having just a platysmaplasty procedure, accepting that this will give only modest results.

Thanks for the question Skylar -
I know that your research and interaction with surgeons has provided you with a great deal of information and it seems like you've gone down pathways that are reasonable places to start.
In my practice, patients that are not facelift candidates because they have a minimal amount of lower face skin excess can benefit from Botox treatments. Given the fact that you've failed that, you may be looking at surgical options. In my experience, Total Fx treatments will not correct these issues.
Platysmal plication with a neck lift may be an option for you. Of course it is difficult to assess without a consultation but many times patients can have excellent results with a combination of a neck lift and platysmal plication. The scars would be similar for a facelift in this case.
Outside of these options there really isn't a great answer.
I hope this helps.

 39 years of age is rather unusual to have significant anterior platysmal muscle neck bands. As long as the skin has excellent tone, a neck lift with a platysma plasty can be performed. This will involve tightening the Platysma muscles from the Adam's apple to the chin area. The platysmal cords are also released down low over the thyroid area which helps them  disappear.  When patients have very loose skin, a lower face and neck lift is required

Immediately under the skin of the neck is the platysma muscle, which you can easily see in a mirror when you clench your teeth and tighten your jaw. In youth, this paired muscle meets in the midline below the chin. With age, the right and left sides of the platysma often separate, producing vertical 'cords' in the anterior neck.

The platysma can be divided anteriorly and tightened during neck lift cosmetic surgery to permanently eliminate these 'cords' and improve the neck contour. One tightened in the midline below the chin, lateral traction on the platysma then creates a 'sling' which elevates the soft tissues below the jawline.

No two facial rejuvenation procedures are ever exactly the same because no two patients are exactly the same. Find an experienced plastic surgeon with expertise in neck rejuvenation, he or she will design a plan with you to help you achieve the results you desire.

I can understand your frustration and can see that you have researched your options well. Botox has limited success with platysmal bands. As far as I am aware, surgically treating the platysmal bands is the only method to give you a reliable result.
Traditionally, we (plastic surgeons) do not do isolated neck lifts in patients that are not having a facelift or have not had a facelift in the recent past. However, someone with isolated platysmal bands can be a candidate for a "neck lift" procedure where we just focus on treating the bands and not truly tightening the skin.
My advice is to look for a plastic surgeon who would do an isolated neck lift.
Good luck.