Treatment of Platysmal Bands with Botulinum Toxin

Abstract

The use of Botulinum toxins for the upper third of the face has been a well-ensconced facet of dermatologic surgery for over a decade. With greater experience with this toxin, additional areas have been treated with varying degrees of success. The middle third of the face as well as the lower thirds of the face may be injected by physicians with advanced technical abilities and knowledge of the relevant anatomy. Within the lower third of the face, the mentalis and platysma are easily treated with Botulinum toxins. Despite the fact that the platysma is not technically part of the lower third of the face, the muscle functions as a depressor of this region and its treatment greatly impacts the overall aesthetic of the entire face. Its treatment with Botulinum toxins is a relatively simple technique that can be mastered by those with experience in the upper third of the face and it can be extremely rewarding for both patient and physician. Newer modalities of radiofrequency, fractional resurfacing, and laser are able to change the texture and color of the neck. Combining these with injections of botulinum toxins offers the opportunity to dramatically improve an area that has traditionally been recalcitrant to rejuvenation.