Nonsurgical treatment of platysmal bands with injection of botulinum toxin A

Botulinum toxin A has been used therapeutically in humans for over 20 years for a variety of medical indications. For the past 7 years, the author has injected it for cosmetic purposes in a variety of muscles of the head and neck. Fifty patient-injections of the platysma muscle were performed in an attempt to correct platysmal banding. An improvement was seen in all patients who presented to the office for follow-up in a timely manner (44 injections). Results were limited by redundant skin. No incidence of dysphagia or airway obstruction was encountered. The only complication noted was bruising. Although at least a small improvement in platysmal banding was seen in all patients, in no patient was there evidence of lifting of the lower face. All results were temporary.