Background: Platysma bands are one of the first signs of aging of the neck. Current theories suggest that these bands develop because of skin sagging followed by loss of muscle tone. Treatment strategies therefore aim to tighten skin and muscle. The aim of the present study was to demonstrate that platysma bands are caused by muscular activity during the aging process and are not secondary to skin sagging. This suggests a new approach to managing platysma bands.
Methods: The authors conducted a descriptive, prospective clinical study of 25 patients who presented with definitive, unilateral, facial palsy following otoneurosurgical treatment. The authors targeted their observations on anterior neck bands. Patients were followed for up to 10 years.
Results: Of the 25 patients, 76 percent had visible platysma bands on the healthy side, but not on the paralyzed side, of their face. Platysma bands were present on both sides in the 12 percent of patients who had a spastic form of facial paralysis. There was no worsening of the platysma band appearance in any patient. No ptosis of the neck skin on the paralyzed side was observed.
Conclusions: This study demonstrated that platysma bands are not related to relaxation of the platysma and skin laxity, but are caused by activity of the platysma muscle. The skin follows the muscle. These observations support a change in surgical management of the aging neck, moving from tightening the skin to denervating the platysma muscle. Further studies need to fully characterize the efficacy and safety of platysma muscle denervation in this indication.
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Article Synopsis
- The study examines the safety and effectiveness of onabotulinumtoxinA (a type of Botox) for treating platysma prominence (PP), which affects the definition of the jawline and creates vertical neck bands.
- Participants with moderate to severe PP received either the treatment or a placebo, and the outcomes were monitored for 120 days.
- Results showed significantly more improvement in those receiving onabotulinumtoxinA compared to the placebo group, leading to better jawline definition and reduced psychosocial impact from PP symptoms.*
Improvement of platysma prominence with onabotulinumtoxinA: Safety and efficacy results from a randomized, double-blinded, placebo-controlled phase 3 trial.
J Am Acad Dermatol
February 2025
Allergan Aesthetics, An AbbVie Company, Irvine, California.
Background: Platysma prominence (PP) refers to the undesirable effects that may occur with platysma muscle contraction.
Objective: Evaluate safety and efficacy of onabotulinumtoxinA for improving Moderate (Grade 3) to Severe (Grade 4) PP in adults.
Methods: Participants were randomized 1:1 to receive a total dose of onabotulinumtoxinA 26, 31, or 36 U or placebo on Day 1 and monitored for 120 days.
Neck Lift to Treat Platysma Bands and Defining Cervical Angle: A Systematic Review and Pooled Analysis.
Facial Plast Surg
October 2024
Department of Plastic and Aesthetic Surgery, Milan Face Institute, Milan, Italy.
Many surgical techniques have been proposed to address the submental-cervical angle in neck lift. Despite the several advances, obstacles persist when dealing with platysma bands and redefinition of the obtuse cervical angle. The aim of this study was to quantify platysma bands recurrence, any neurovascular damage, and other complications following neck lift procedures involving platysma muscle.
View Article and Find Full Text PDFAnatomical Guidelines and Technical Tips for Neck Aesthetics with Botulinum Toxin.
Arch Plast Surg
September 2024
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea.
Botulinum toxin can be used for various purposes to enhance neck aesthetics, addressing concerns such as platysmal bands, optimizing the cervicomental angle, preventing worsening of horizontal neckline and decolletage lines during aging, submandibular gland hypertrophy, and hypertrophied superior trapezius muscle. Understanding the anatomy of muscles such as the trapezius, platysma, and submandibular gland is crucial for achieving desirable outcomes with botulinum toxin administration. Techniques for injecting botulinum toxin into these muscles are discussed, emphasizing safety and efficacy.
View Article and Find Full Text PDFFixation of Superolateral Platysma Flap to the Mastoid Fascia: A Novel Isolated Neck Lift Technique.
Aesthetic Plast Surg
November 2024
Mudanya University Faculty of Health Sciences, Çağrışan Mah. 2029 Sk. No.2, 16940, Bursa, Turkey.
Article Synopsis
- This study assessed a new neck lift technique involving the superolateral platysma flap, focusing on its effectiveness for aesthetic improvement and patient satisfaction over 18 months post-surgery.
- 145 female patients were evaluated using the Global Aesthetic Improvement Scale (GAIS), showing significant improvements in areas like the cervicofacial angle and jowls, with over 90% satisfaction reported.
- The procedure had manageable complications, including minor bruising and suture exposure, but allowed for quick recovery and high satisfaction rates among patients.
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