Botox Neck Lift

I read about a Botox neck lift. What is this and does it work? I thought Botox was for frown lines?

Doctor Answers 41

Botox doesn't lift, it "relaxes" the muscle bands

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You are correct that Botox is typically used for the frown lines between the eyebrows.  Overuse of the muscles between the eyebrows causes deep vertical lines which we call frown lines.

If we look aging necks in the population, people with thinner necks with minimal fat tend to have "muscle bands" or platysmal muscle bands.  This is a thin sheet-like muscle under the neck skin.  The front edge of the muscle is what forms the edge of the muscle band.

If we lay a bed sheet on the ground with a clothes line under the bed sheet, then we pull on the clothes line, the clothesline will tent the bed sheet.  This is what happens with neck muscle bands.  As the platysmal muscle band contracts, it is very similar to the clothes line tenting the bed sheet.  

Botox is a neurotoxin, or a poison which selectively paralyzes or weakens the muscle that it is injected into.  The effects of Botox are temporary, and the strongest effect of paralysis last only about a month, but residual weakness of the muscle persists for up to 4-5 months.  The muscle strength gradually returns over the months after injection.

Even when the Botox completely paralyzes the platysmal muscle bands, sometimes the muscle already has skin wrapped around it, and the muscle bands look the same.  Maybe less "tense" but still there all the same.  The only way it really works is if the muscle bands protrude when the person "clenches" their jaw or flexes their neck muscles, but the neck profile is perfect when the person is relaxed. 

Only in these people does the botox on the muscle bands prevent the neck band from forming.

I hope this explanation makes some sense.


Dr. Yang

New York Facial Plastic Surgeon
4.8 out of 5 stars 35 reviews

The Botox neck lift refers to the use of Botox...

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The Botox® neck lift refers to the use of Botox® Cosmetic to relax muscular bands (Platysmal bands) located immediately under the skin of the neck--not a true neck lift. You are correct, Botox® Cosmetic is only approved for the forehead frown lines.

The use of Botox® Cosmetic to lift the neck is off-label and has some risk. In general, cosmetic use in the neck has been reserved for people with little fat under the chin and mildly hanging skin and muscle bands. By relaxing the muscle band, the skin appears to droop less. If a botulinum, like Botox®, is injected too deeply, the ability to swallow or move the head normally may be affected.

Julius W. Few, MD
Chicago Plastic Surgeon

Botox in the Neck vs. Neck Lift.

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As we get older, the skin and soft tissues can sag.  In the neck there may also be "banding", where the neck muscle enveloping the neck can form taught band like thickening of tissue.  Some have used Botox into these bands to try and relax the muscle and obtain improvement.  One has to be very careful as there are many structures in the neck that one does not want injured.  The results of this treatment are temporary.

A neck lift addresses the soft tissue droop and usually will also address the band issue.  the results are also more permanent.  It is an operative procedure.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Can Botox lift the neck?

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In my opinion the so-called Botox neck lift is a mythological creature that is often talked about but never seen.  Botox is a relaxant, not a tightener.  It is useful to relax some of the tight linear bands of muscle that occur in the neck, but it isn't going to significantly improve neck tone or definition.

The good news is that there are a number of good neck lift techniques that can be customized to your particular situation.  If you are in excellent health and of the proper disposition these can sometimes be done under local anesthesia with a relatively quick recovery.

Please go to a highly qualified surgeon for a neck lift procedure.  There are many traps for the practitioner who has just completed a weekend course.  This is not surgery for amateurs.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Neck bands are caused by muscle tension - Botox can help smooth the neck

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I did a study in the anatomy lab on the muscular bands in the front part of the neck. The neck muscle (platysma) actually thickens in the front part of the neck. Some people have a lot of muscular tension in the muscle which forms cords in the front of the neck. Botox placed into the cords relaxes the downward pull of the muscles and softens the neck.

This is not the same as surgical tightening, but the effect can be noticeable for many people. I suggest to patients that are interested to try it once to see how they may benefit.

Edward Szachowicz, MD, PhD
Minneapolis Facial Plastic Surgeon
4.6 out of 5 stars 14 reviews

Botox cannot create a lift

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The term Botox neck lift isn’t really a real treatment term.  Botox by definition is a neurotoxin that relaxes muscles, which can be the cause of wrinkling.  Other than a very minor lift of the brows, Botox cannot “lift” anything.

However it can be used to reduce the appearance of wrinkles in the neck and to relax certain bands of muscles in the neck to create a temporarily smoother appearance.  FDA had not approved these uses for Botox though and they come with their own set of risks.

Additionally these treatments can be costly and yield varying results which you may or may not be happy with.  So “can” there be benefit to using Botox in this manner?  Yes for the right person with the right set of parameters.

Is there typically a huge benefit to going this route?  No, there are better treatment options than this that will yield much better and more reliable results that you should consider first.  Talk with your doctor and schedule a consult to help you decide the right treatment options for you.

Scott W. Mosser, MD
San Francisco Plastic Surgeon

Botox and necklift

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Botox has been described as a partial remedy for platymal bands in the neck, although the FDA has not approved it for that purpose cosmetically. Because of the cost and temporary nature of the product, as well as the fact that neck bands are usually accompanied by loose skin, I do not consider it a great solution. A lower facelift/necklift with formal platysmaplasty is still, by far, the procedure of choice to deal with neck bands.
Botox may offer a short-term, minimally-invasive stopgap maneuver to make the bands less prominent, but results certainly may vary. Again, remember that Botox has a very specific cosmetic indication approved by the FDA, although it is commonly used in other areas with favorable results. Speak to your surgeon at length to learn about your options after a proper, comprehensive consultation and examination.

Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 22 reviews

Botox neck lift

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Botox can be used to rejuvenate the neck in the following instances:

  • Help decrease presence of platysmal bands
  • Selectively weaken the front neck muscles so that the back neck muscles pull stronger, giving a tighter neck and jawline. 

Botox is not the treatment of choice for the neck and its best role is in an adjunctive manner.  Surgery represents the best treatment for neck rejuvenation.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Botox vs. Neck Lift

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A neck lift can be one of the most rewarding procedures for patients. In our office, patients are amazed at the beautiful neck we can create with work on the skin, fat, and muscles. By performing work on all three layers, patients are able to achieve a youthful neck they had always dreamed of. In contrast, BOTOX only addresses the muscle and can only soften platysmal bands and will have no effect on the skin laxity or fat deposits.

Ankit Desai, MD
Jacksonville Plastic Surgeon

"Botox Necklift" is a misleading marketing term - beware

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Unfortunately as more and more practitioners start incorporating Botox and other injectables into their family practices , naturopathic clinics and dental offices, the marketing of these treatments starts to become more and more misleading.

Yes, Botox can be used in the neck to relax Platysma bands but when this is marketed as a “neck lift”, it’s just not true. Botox is a muscle relaxant. It does the exact opposite of lifting the neck.

Botox is a very effective muscle relaxant that gives great results when used properly. It can not be used to perform a “neck lift”.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 114 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.