How to treat vertical neck bands?

Question

I'm a 48 year old female and I've developed some vertical bands under my chin about 2 inches long which look worse when I turn my head. I've consulted a surgeon who advised it wasn't bad enough for any surgical options and I've had radio frequency which didn't work. Neither did Botox. Any suggestions?

Jason Emer, MD · Answer

"Injecting soft fillers like Belotero in this area can reduce lines, wrinkles and folds as well as improve skin texture with long-term collagen production. Fillers are being used more frequently to contour and lift rather than solely line fill. Of course, fillers are best used in combination with lasers and microneedling with PRP to get the optimal outcome.

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"

Sam Speron, MD, FACS · Answer

The neck can have vertical wrinkles and rings from an early age (genetics play a key role) as well as from sun damage and aging in almost everyone. They can be super annoying and are hard to get rid of.
Surgically removing them is the best way to get rid of them but this can leave a lot of scars in very visible areas which most people don’t want.
These rings are usually at the skin level. There are several nonsurgical and surgical options to consider. Some can be done at the same time. Surgery combined with injections and laser treatments before or after surgery is usually the biggest difference.  For people not interested in surgery, the hyaluronic acid injections and laser treatments are the most reasonable options, maybe combined with a chemical peel.
These procedures can be done safely in the office and the results are often very satisfying. An in-office private consultation and examination with a board-certified plastic surgeon would be the best way to fully  address your specific concerns and determine the right treatment plan.

Alejandro J. Quiroz, MD · Answer

Thank you for your question. Without pictures si very difficult to know for a fact what are those bands but in most of the occasions those bands are created by the contraction of the platysma muscle. There are several ways to treated but radiofrequency will not help and the most effective way is surgery

Christian Subbio, MD · Answer

In general, if you have already tried the noninvasive treatments for this, the logical next step is some form of neck lift.  Whether or not this is an isolated platysma focused treatment, versus a skin excision treatment as well, depends upon your exam.  Without photos, it is difficult to really give you well tailored advice.  Anything otherwise would simply be guessing.  I would advise either repeat post with some photos, or better yet, visit with a well-qualified plastic surgeon for an in-person examination to better go over your options.Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Ross A. Clevens, MD, FACS · Answer

Thank you for your question, AngieBei. The Laser-Assisted Weekend Necklift is an ideal solution for the 40-55 year old with
early sagging of the upper neck and jowl area. The procedure is usually performed under local
anesthesia with sedation. After creating a small, hidden incision in the natural
fold under the chin, I use a
laser, liposuction, and sometimes a chin implant to improve the appearance of a
sagging face, jowls, and neck. The result is a natural appearance with minimal discomfort and the convenience of a short recovery of a several days. Always consult with a board certified facial plastic surgeon. Best wishes,

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Hi AngieBeiGreat question.This occurs as a result of muscle separation of the neck called the platysma muscle, leaving you with what people often term 'turkey neck'Neck rejuvenation or neck lift surgery is one of the most popular cosmetic surgery procedures. For those who have excess fat under the chin but still have good muscle tone and skin, liposuction of the neck will be sufficient. If the skin has lost elasticity, removal of excess skin (Neck Lift Surgery) to tighten and tone the neck will also be required.An incision under the chin can be made to gain access to the muscle. The muscles are then sutured together, which tightens the neck foundation and the extra loose skin can be draped over the tightening muscle to improve the neck contour. Good Luck with your journey

Nicholas Jones, MD, FACS · Answer

Thank you for your question.  The vertical neck bands (platysmal bands) represent laxities in the superficial muscle of the neck, the platysma.  The bands can be treated nonsurgically with Botox.  Botox usually works best in patients with little to no skin excess and strong bands.   For others, surgical treatment in the form of a platysmaplasty (neck lift) may be indicated.  The procedure can involve tightening the neck muscles, removing excess fat, and directly cutting the muscle.  To see if you are a candidate, an evaluation by a local board certified plastic surgeon would probably be the next best step.Good Day

Todd C. Miller, MD · Answer

Hi AngieBei, unfortunately, the neck is one of the areas where we first see signs of aging. It sounds like you have already tried non-invasive options with no improvement. In cases like yours I would go to the next step which would entail a neck lift in order to tighten the bands and restore the contour to your neck. Pictures would be very helpful. Follow up with an experienced facial plastic surgeon who can give you options.

William Portuese, MD · Answer

Vertical bands in the neck are caused by shortening, and contraction of the platysma muscle. A neck lift with a platysma plasty can address removal of the these bands. If there is excess skin present in the neck, a lower face neck lift will be required.  The skin tone in the neck will be the determining factor which procedure to perform. For many examples of neck lifts with platysma plasty, please see the link below

Jawed Tahery, FRCS · Answer

Hi,This is due to dehiscence of the platysma muscles in the midline of your neck!Botulinum toxin in specific area can help, but surgery by tightening the muscle in the midline is the definitive answer!Best wishesMR J Tahery ChesterUK

How to treat vertical neck bands?

Answers (14)

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