This is a study in the new Aesthetic Surgery Journal February 2019. “Botulinum Toxin Treatment for Mild to Moderate Platysma Bands: A Systematic Review of Efficacy, Safety and Injection Technique.”
What the what?
First let me decode. We are talking about the neck, particularly those bands that form in the neck. This is due to a very superficial muscle called the platysma, which forms an apron on your neck. Commonly two bands (or more) will form, running vertically down your neck (“vertical banding”). This makes your neck look old.
The neck has always been an issue. If you talk to someone who is over the age of 50, it is like you have driven off some virtual cliff of aging, and much is due to the neck. Selfies and facetime don’t help us forget about it. So if you don’t want to invest in tons of scarves and turtlenecks, or if you aren’t ready for a facelift (which is the same as a necklift or lower facelift), what can you do?
Drumroll…. Enter Botox.
So this is not new. Many of us have been doing this for years. This study tried to evaluate how to address these bands the best. This was a literature review, with a total of 78 patients doing injections.
Findings:
- a response rate of 94% was seen
- it was seen after 14 days
- mean age was 52
- the effect decreased over time, so by 3 months the improvement was cut in half
- the studies all used 20 units of botox per band (so in a neck, usually with 2 prominent bands, this would be 40 units or more)
- These were done intramuscular, spaced 1-2 cm apart, with 2- 6 injections per band
- The most common complication was a bruise.
What do I think?
This is not new. As I said above, many of us have been doing this for years. I think the efficacy varies from person to person. To do it justice, you need to use a fair amount. And, as with the crows feet area around the eye, I feel it wears off a little faster than other areas. But for some of my patients, it is transformative.