Botox for the Neck

The skin on the neck can be damaged by the sun causing discoloration. It can loose its resiliency, and sag. The muscle can form cords that stick out. The fat can shift around creating hanging pockets. Lasers help the discoloration, while liposuction addresses the fat. But the necklace lines and cords or bands can be treated with Botox.

History
Patients should be asked what about the neck they want improved. They can bring in pictures of when they were younger to help illustrate this. Neck injection should be avoided in patients with neck weakness, swallowing problems, or chronic neck pains. Patients should be evaluated for neck bands, necklace lines, abnormal appearing skin, fat collections, and abnormal jaw shape with the patient at rest and neck contracted. The patient is instructed to clench their teeth and pull down the corners of the mouth to show the neck bands. The operator will pinch the band between the thumb and finger and inject the band. 3-10 units are placed into each site every 1-1.5 cm along the entire length of the band. Thin bands will need 15-20 units and thick bands may need 30 units. A total of 50-100 units can be used. More may risk neck weakness and swallowing problems.


Injecting neck bands Injection sites of neck bands

Before and after treatment of neck bands

Neck lines are treated with 1-2 units every 1 cm along the wrinkle. Injections are into the skin. Deeper injections may cause swallowing problems. Improvement may be noted at 5-14 days. 98.5% of patients in one study, from patient and physician input, reported good to excellent results. Side effects include swelling, redness, bruising, muscle soreness, neck weakness (can’t bend the neck forward while lying down), headaches, hoarseness, and swallowing problems. Patients should not rub the area for 24 hours and not lie flat for 4 hours. Complications usually resolve in a few weeks. Ice can help the bruising and pain.