On the neck, horizontal lines known as necklace lines and vertical ridges, called platysmal bands, may be treated with BOTOX®, and in some instances with advanced dermal fillers. In this section, we will briefly discuss how these may be treated.
Note: Before undergoing any procedure discussed on this web site, make sure that your physician has extensive experience with the specific procedure. Medical schools have only recently begun to teach some of these procedures. As with any medical procedure there are varying degrees of risk involved. Please consult your physician.
Exposure to the elements (photodamage), loss of collagen and elastin, as well as laxity of the platysma neck muscle can contribute to formation of horizontal wrinkles and lines, commonly called necklace lines. These lines may be treated with BOTOX®, placed above and below the lines, at points 1 – 3 centimeters apart, along each line. Physicians will take care not to place too much BOTOX® in the first treatment session, so as not to affect a patient’s ability to swallow. It is common to have a patient come in a couple weeks after treatment, in order to augment the treatment with a second BOTOX® application.
While it may take a greater amount of BOTOX® to treat necklace lines than most facial areas, the results may last longer than is typical with other cosmetic BOTOX® treatments because of less muscle movement on the neck. If a patient is diligent in returning for repeat treatments as soon as the effects of the BOTOX® treatment subsides, over time, the etching of the lines may be diminished or eliminated.
In addition to BOTOX®, some physicians may use a soft dermal filler, such as Juvederm® or Restylane®, placed immediately underneath each line.
As we age, the platysma neck muscle may become more lax or more hypertrophic (enlarged). When this happens, vertical ridges or bands may become more pronounced when the muscle is contracted. BOTOX® may be used to relax the platysma muscle and diminish the appearance of the bands.
During treatment, the physician will typically ask the patient to contract the neck muscle and then place BOTOX® along the ridges of the muscle. BOTOX® is usually placed 1 – 3 centimeters apart along each band. Similar to the treatment of necklace lines, the physician will be careful not to place too much BOTOX® in the first treatment, so as not to affect a patient’s ability to swallow. The patient may return a couple of weeks after the first treatment if more BOTOX® is needed.