I would like advice on non-surgical procedures to deal with excess skin/bands on my neck. (Photo)

I had 15 CCs of Botox 13 days ago and do not see desired effects. Should I try Botox again with greater amount of CCs? Would cool sculpting be an option? I am 36 years old and would like to avoid surgery at this point.

Doctor Answers 16

Seek out a physician who specializes in non-surgical skin tightening

Botox works to relax tense muscles, and while neck banding can be treated with Botox, it needs to be caused by muscle tension in order to have the desired effect. It’s impossible to tell if the Botox has had any effect here, as you have not provided before photos.

However, what I can currently see is excess skin on the neck. There are a number of non-surgical skin tightening treatments available, including Ultherapy, RadioFrequency Microneedling, Thermage, ThermiTight (this is what's called a "minimally invasive" procedure).. All of these options can offer great results- it’s just about choosing the right option for your skin (based on an in-person exam) and planning out a treatment schedule that works for your lifestyle. Seek out a physician who specializes in non-surgical skin tightening and has a few of these devices – that way you can be sure to get the right treatment for you.


Livingston Physician
4.8 out of 5 stars 17 reviews

Platysmal bands improvement

To be correct, you probably got 15 units of Botox for this problem. I find it only works when there is tension in these bands. I don't think that more will be beneficial. In my experience, the only thing short of surgery that will work for this is PDO threads. Even though I'm a big advocate for Infini, I haven't found it to work well for these. I have seen threads work. This is a new procedure in the US and it is very user dependent. Please see an experienced provider for this. It requires a single or double barbed suture to correct this on each side possibly. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Botox for Neck Bands

Thank you for your question Hope1023. Botox is a purified protein used to address wrinkles associated with facial expression. It can also be used to address neck bands that can be seen when making certain expressions. For my patients I typically use 8-12 units per band and there can be up to four bands. It is important to understand that Botox dosing goes by units, not cc. Please follow up with your doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

How to diminish appearance of platysma bands and lax skin

Thank you for your question. ThermiRase and ThermiTight are non-surgical procedures that are extremely effective in treating your areas of concern. These procedures are usually done under local anesthesia, so there is absolutely no downtime. ThermiRase can diminish the appearance of the platysma bands on the neck while ThermiTight can tighten lax skin, melt fat and stimulate collagen production in that area. They are both non-surgical and micro-invasive. ThermiRase and ThermiTight procedures are performed under different set temperatures to achieve the desired effect. Moreover, the set temperature for melting fat and tightening skin varies too (just something to be mindful of as you do your research and consult with experts in your area). Please check out the Thermi website for more information. Good luck!

Brian M. Kinney, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 10 reviews

Non-Surgical options for tightening of the neck

While Botox treatment in the "neck" can help to relax the Platysmal bands, an option for tightening of the neck would be a procedure know as ThermiTight. This non-surgical treatment uses a small probe inserted under the skin to heat the subdermal tissue. Combined with RF on the surface of the skin, ThermiTight causes collagen remodeling which results in the tightening of the skin.

Kimberly Moskowitz, MD
Panama City Phlebologist

I would like advice on non-surgical procedures to deal with excess skin/ bands on my neck.

Thank you for your question. You could schedule a follow up with your injector and be assessed for an increased amount of Botox. Perhaps you will require a slight adjustment if this is your first time receiving Botox in that area. CoolSculpting to that area is indicated for fat reduction, from your photos, it does not seem as though you are a candidate. 

Hope this helps, 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 427 reviews

Neck Skin and Platysmal Bands -- VASER Hi Def Liposuction/ThermiRF, Venus Legacy/Thermage/Ultherapy, Botox/Dysport

ThermiRF/VASER, botox, ultherapy/thermage can do very well to treat this area.  I suggest you see an expert for an evaluation or treatment.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Neck bands

Hello, and thanks for your question. I'm sorry you did not get the result you had hoped for. 

You likely need more Botox, and may also need a skin tightening procedure such as Ulthera or Forma. To maximize the likelihood of a favorable outcome, I recommend that you only get treated by a well-trained and experienced dermatologist or plastic surgeon.

Hope this opinion is helpful to you. Best of luck, Dr. Frucht.   

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Neck bands

It is unclear why you have neck bands at this age. More history would be helpful.  A neck lift may be a good option.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

I would like advice on non-surgical procedures to deal with excess skin/bands on my neck.

Hello Hope 1023,

The gold standard to treat those bands is surgery,  But you indicated that is not an option.  Botox, Dysport, and Xeomin can all help to soften the bands (which does appear to have happened in your case) but not necessarily get rid of them.  Since you have multiple bands you could have a higher dose of Botox to see if you get the results you want.  Cool sculpting is more for fat in that area as is Kybella.  Ultherapy can help tighten the skin to some extent.  

I hope this helps and good luck.  

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