Botox doesn’t lift, it “relaxes” the muscle bands

Q: Botox Neck Lift

I read about a Botox neck lift. What is this and does it work? I thought Botox was for frown lines?

A: You are correct that Botox is typically used for the frown lines between the eyebrows. Overuse of the muscles between the eyebrows causes deep vertical lines which we call frown lines.

If we look aging necks in the population, people with thinner necks with minimal fat tend to have “muscle bands” or platysmal muscle bands. This is a thin sheet-like muscle under the neck skin. The front edge of the muscle is what forms the edge of the muscle band.

If we lay a bed sheet on the ground with a clothes line under the bed sheet, then we pull on the clothes line, the clothesline will tent the bed sheet. This is what happens with neck muscle bands. As the platysmal muscle band contracts, it is very similar to the clothes line tenting the bed sheet.

Botox is a neurotoxin, or a poison which selectively paralyzes or weakens the muscle that it is injected into. The effects of Botox are temporary, and the strongest effect of paralysis last only about a month, but residual weakness of the muscle persists for up to 4-5 months. The muscle strength gradually returns over the months after injection.

Even when the Botox completely paralyzes the platysmal muscle bands, sometimes the muscle already has skin wrapped around it, and the muscle bands look the same. Maybe less “tense” but still there all the same. The only way it really works is if the muscle bands protrude when the person “clenches” their jaw or flexes their neck muscles, but the neck profile is perfect when the person is relaxed.

Only in these people does the botox on the muscle bands prevent the neck band from forming.

I hope this explanation makes some sense.


Dr. Yang