Platysmal bands are the vertical cords that often appear in the neck as one of the first signs of aging. They can make the neck appear saggy and pull down on the lower face, leading to jowls and horizontal neck lines.
Treatment options for platysmal bands include Botox, dermal fillers, and neck lift surgery. While all treatments can improve the appearance of these creases and reduce sagging, they don't permanently resolve their presence.
The most common way to relax these ridges is through injections of muscle-relaxing products like Botox or Dysport, which work by blocking nerve signals that cause the muscles to contract. These injections can be done in the clinic during a single visit lasting less than an hour.
Injectables can be combined with surgical techniques for long-lasting results, and these can include a corset platysmaplasty (also known as a "Nefertiti lift"), multiple Z-plasties, and bilateral rein plication sutures to tighten the muscle, improve jawline definition, and avoid the need for future surgery.
Botox can also be used to prevent future sagging in the neck by relaxing the neck muscles which keeps the skin looking smoother and younger. The results of this non-surgical treatment typically last for three months before touch ups are needed.
New research suggests that platysmal bands are caused by muscle activity, rather than sagging skin, and therefore should be treated differently than the current approach which is to tighten the skin and muscle. This has led to a change in surgical management of the aging neck from tightening skin and muscle to denervating the platysma muscle.