What is the best option for vertical neck band? Also, what can I do for bulging vein in forehead? (photos)

Question

I recently turned 34 and feel like it's time to look into Botox and or fillers. I have a vertical neck and that seems to show all the time regardless of the position of my head.and when I clench my teeth it's extremely crazy looking. I also have a large vein in my forehead that bulges when I laugh… What would be your suggestion is to fix these?

Jason Emer, MD · Answer

I like fillers for neck bands in combination with lasers or microneedling/PRP. For forehead veins, I recommend filler in order to camouflage the veins in addition to laser and skin care treatments to improve texture and tone.I suggest seeing an expert.   Best, Dr. Emer.

Andrew Pichler, MD · Answer

Botox/Dysport are excellent way to tame those neck bands. Sometimes the treatment even lasts longer in the neck then other areas of the face. As to facial veins, they may require laser treatment but it needs to be evaluated hands on.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question muddytutus. Botox is
a purified protein used to address wrinkles associated with facial expression. Botox can be used to address neck bands. Usually either two or four bands are seen. For my patients I typically use 10 units of Botox per band. Veins on the face can be addressed with lasers such as Nd:YAG, KTP, pulsed dye, or IPL. Please consult with
a doctor for specific recommendations. Good luck!

Shaun Patel, MD · Answer

Botox injection can improve the vertical neck bands demonstrated on the photos above. These bands are the result of platysmal muscle contraction and so relaxing the platysma with Botox will soften the bands. As for the forehead vein, a 1064 nm laser maybe helpful but honestly I would probably just leave the veins alone.

Steven F. Weiner, MD · Answer

Most of these bands can be improved with the use of Botox in the platysmal bands. The bands at rest won't respond as well and are harder to take care of. I'd still try Botox on these too. If no improvement, consider a skin tightening procedure such as Infini or Thermi RF. For the forehead vein, a 1064 laser is able to take care of some of these. If it is not too large, you can give it a try.

William Marshall Guy, MD · Answer

Hello Muddytutus,Given your age and the appearance of your band, I would recommend Botox.  What you are seeing is the edge of a muscle (called the platysma).  When you clinch down, you will always be able to see the bands.  However, for the band that is present at rest, Botox can help to soften it and if not completely make it disappear, get it close.  Although surgery is an option, that would be more aggressive than you would need at this point, in my opinion.For the vein in your forehead there really aren't good options.  It serves a purpose and if you try to do something that removes it, you are just as likely to see new veins pop up to drain that area.  I'd recommend you consult with a facial plastic surgeon who does his or her own injections for your Botox to minimize the risk of any adverse outcomes.I hope this helps and good luck.

Melvin Elson, MD · Answer

The best treatment for the bands is Botox but be sure you see a board certified dermatologist or plastic surgeon who is experienced in this as there are possible side effects and it needs to be done slowly. as for the vein I would suggest you leave it alone

Jon A. Perlman, MD (retired) · Answer

Vertical neck bands are usually due to a combination of some skin laxity and prominence of the platysma muscle.  Your best option is to have Botox or Xeomin injected into the band in my opinion.  Often the results are dramatic and last for many months.  I would leave the forehead vein untouched.  Best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California

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