A smooth, elegant neck does more for the face than most people realize. When the platysma, a sheet-like muscle that runs from the jawline down to the collarbones, starts to pull or thicken with age, vertical cords known as platysmal bands show up in photos and mirrors. They catch the light, create a “stringy” look, and make the lower face appear heavier. Botox, used strategically, can soften these bands and restore a calmer contour to the neck and jawline. If you have been searching for “neck botox” or “botox neck bands,” this guide walks you through what a careful, evidence-based approach looks like, from candidacy and technique to safety, aftercare, units, and results.
What platysmal bands are and why they form
Platysmal bands are the vertical ribbons under the skin that tighten when you grimace, clench, or sometimes when you simply talk. In youth, the platysma behaves like a smooth sheet. With time, it separates into distinct cords and can over-recruit, tugging the lower face downward. You may see:
- Bands that stand out when you clench your teeth or say “eee,” then fade at rest. Bands that remain visible even when your face is relaxed, especially under overhead lighting. A sharper demarcation between the jawline and neck, with the skin in between looking looser.
The usual culprits are muscle hyperactivity, thinning skin, reduced collagen, and changes in fat distribution. Sun exposure accelerates the process. Weight loss can make bands more apparent. Genetics sets the baseline.
Botox (onabotulinumtoxinA) reduces muscle activity by blocking the nerve signal at the neuromuscular junction. When placed properly along the platysmal bands, it softens their pull. The surface looks smoother and the downward tension on the jawline eases, often enhancing a subtle jawline lift. Patients who get regular Botox for wrinkles in the upper face are often good candidates for neck botox as well, provided their injector is experienced with the anatomy of the lower face and neck.
What Botox can and cannot fix in the neck
A strong result depends on matching the tool to the problem. Botox is excellent for dynamic issues, especially bands that pop with movement. It can also improve fine horizontal necklace lines modestly, but those often respond better to skin-directed treatments like microneedling, biostimulatory filler, or laser. Botox will not remove significant skin laxity or a true “turkey neck” caused by redundant skin. It does not dissolve fat; submental fullness is better treated with fat reduction options or surgery. If your concern is primarily loose skin or large folds at rest, platysmal bands botox may still help, but you should set expectations for a softer, not surgical, outcome.
In practice, I often combine Botox with collagen-stimulating treatments over time to improve the overall envelope. Patients who ask about “botox for neck tightening” usually benefit from a blended plan: Botox for the muscle, energy devices or topical actives for the skin, sometimes microdroplet filler for stubborn lines. The right mix comes from a careful in-person evaluation.
How we evaluate candidacy
During a botox consultation, I start with dynamic assessment. I ask the patient to grimace, say “eee,” swallow, then relax. I map the bands visually and with gentle palpation. I note the width, length, and how strongly they pull. I also watch how their chin and depressor anguli oris (the muscles that pull the corners of the mouth down) behave, because over-treating the neck while ignoring lower-face antagonists can create imbalances.
Key questions I’ll ask:
- Do the bands bother you more in photos, or do you notice them constantly at rest? Have you had prior neck botox or other neck procedures? Do you have any history of dysphagia (trouble swallowing) or neuromuscular conditions? Are you on blood thinners or supplements that raise bruising risk? What is your daily posture? Heavy phone use with head down can aggravate lower-face and neck strain.
If your bands are strong and your skin quality is fair to good, cosmetic botox in the neck can be one of the highest value interventions. If the bands are mild or your primary issue is crepey skin without much movement, we may steer the plan toward skin-focused therapy and hold off on botox injections until there is a clearer muscle-driven component.
The injection pattern, in plain terms
The technique for platysma varies by injector. The most common pattern targets the visible bands with small aliquots, placed superficially along their length. Imagine dots placed a finger’s breadth apart along each cord, often from just below the jawline down to the mid neck. In some patients, placing a series of microdroplet points in a grid pattern across the anterior neck softens both bands and subtle necklace lines. The injector’s touch should be gentle and controlled, because depth matters. Too deep, and the product can affect swallowing muscles or the strap muscles of the neck. Too lateral, and you risk the smile muscles. Careful technique, layered knowledge of anatomy, and conservative starting doses are the safeguards.
I usually start with the bands that dominate under animation. Once those are tamed, secondary bands are addressed in future sessions if needed. Patients often assume more units equal better results, but the neck rewards finesse.
How many units of Botox you might need
There is no one-size number. Most adults fall somewhere between 20 and 60 total units for neck bands, split across both sides. A petite patient with two narrow bands might require 16 to 24 units. A patient with four strong bands and thick muscle may do better with 40 to 60 units. If we add small points across the anterior neck, that can add another 6 to 20 units depending on the grid size. The botox cost per unit and the number of units together determine your final price, so during your botox appointment we map both your anatomy and your budget.
Expect a range at your first visit, then a precise number after your muscles declare themselves. As with forehead botox or glabella botox, I prefer to err slightly conservative in a new patient and layer at a two-week follow-up if needed.
What the appointment feels like
A typical botox treatment for platysmal bands takes 10 to 20 minutes. You arrive with a clean neck, or we cleanse it. No numbing cream is usually necessary, but it can be applied for comfort. The needles are tiny. You will feel a series of quick pinches and some pressure. Slight burning is normal for a second or two as the product spreads.
When I teach injectors, I emphasize patient positioning. Slight recline, chin in neutral, light tension to bring the band forward without straining. We confirm landmarks before each injection. I keep the dose per point small and place points superficially. Afterward, I press gently to reduce any oozing, then apply a cool compress if the skin looks flushed.
You may walk out with a few raised bumps that look like small mosquito bites. They flatten within 20 minutes. Makeup on the neck is usually unnecessary, but if you want to apply it later in the day, that is fine once the skin is fully dry and calm.
When results show, how long they last
Most people start to see softening in 3 to 5 days. The full effect settles between day 10 and day 14. If you are planning for a photo-heavy event, schedule your treatment at least two weeks ahead to allow adjustments. Results typically last 3 to 4 months, sometimes up to 5 in smaller, less active muscles. Heavier bands or athletic patients with strong musculature may metabolize faster and find their sweet spot at 12 to 14 weeks.
As with wrinkle botox on the forehead or crow’s feet botox around the eyes, consistent maintenance gives the best long-term payoff. Muscles learn. Over a year of regular appointments, most patients find they either need fewer units or enjoy a longer runway between visits.
Safety, side effects, and how we avoid problems
The neck has more moving parts than the glabella or forehead, so the injector’s skill matters. The most common side effects are mild and short-lived: pinpoint bruises, swelling, and tenderness for 24 to 48 hours. You may notice a light, “looser” feeling in the anterior neck, which is exactly the goal. What we work hard to avoid are effects on swallowing or speech. With superficial placement and appropriate dosing, these are uncommon. If you notice difficulty swallowing liquids, it is typically mild and temporary, resolving as the medication lifts. It is quite rare to see significant weakness when a certified botox injector follows proper landmarks.
Other considerations:
- If you already have neck instability, recent neck surgery, or a known neuromuscular condition, platysma injections may not be appropriate. Your botox doctor should review your medical history carefully. Blood thinners, fish oil, and high-dose vitamin E increase bruising risk. You should not stop prescribed medications without guidance, but your injector can time the procedure and provide aftercare to minimize marks. If you are pregnant or breastfeeding, we defer cosmetic botox. Wait until it is clearly safe to proceed.
Choose a trusted botox injector who can show you real case photos and speak clearly about risks. “Top rated botox” marketing claims are easy to write; judgment at the needle tip is what matters.
Aftercare that actually helps
Once the injections are done, you can return to your day. Most people head back to work or out to lunch. Keep your head in neutral for a few hours. I recommend avoiding heavy downward flexion for the rest of the day, since prolonged phone posture can push product subtly. Skip strenuous workouts and saunas until the next morning.
One list worth keeping on your phone for the first 24 hours:
- No massaging the neck or heavy rubbing while cleansing. Delay hot yoga, steam rooms, or prolonged heat exposure. Keep alcohol light to reduce bruising risk. Sleep on your back if you can, with a thin pillow to keep the neck neutral. Call your botox provider if you notice unusual swallowing difficulty or anything that worries you.
That is it. No elaborate rituals. Keep skincare simple that evening. Resume normal routines the next day.
What results look like in real life
Patients often tell me they look “less tense” or “less stringy,” especially in candid photos and video meetings. The bands soften, the skin reads smoother, and the jawline looks more lifted because the constant downward tug has quieted. If you also receive masseter botox for jaw clenching or TMJ botox, the combined effect can be a more sculpted lower face without altering your natural expression.
One patient in her mid forties came in after noticing vertical cords in profile photos at a wedding. Her bands were strong with animation, moderate at rest. We used 36 units across three bands on each side. Within two weeks, her cords barely showed when she spoke. She returned at three months requesting a repeat, and we adjusted to 30 units as her bands were already less active. Over a year, she shifted to a four-month interval and now thinks of it as routine maintenance, like forehead lines or 11 lines between the brows.
Cost, pricing models, and value
Practices price botox by the unit or by the area. In markets where the going botox price per unit ranges from roughly 10 to 20 dollars, a 30 to 50 unit neck treatment falls near 300 to 1,000 dollars. Pricing also reflects injector experience, clinic overhead, and geographic demand. Beware “cheap botox” deals that promise dramatic results at extremely low unit counts, or flat-fee offers that do not explain dosing. You want transparent units and a plan that fits your anatomy.
Ask about follow-up policies. Many botox med spa offices include a check at two weeks and a small touch-up if appropriate. Specials do run seasonally, and a reasonable botox payment plan can help if you are folding this into a larger rejuvenation plan with fillers or lasers. Just make sure your choice of botox clinic prioritizes quality and safety over bargains.
Technique choices that separate good from great
With platysma, the details matter. A few examples:
- Depth of injection. The platysma sits just under the skin. Shallow placement places the product where it needs to act. Going too deep risks the strap muscles and can change the feel of swallowing. An experienced botox injector will stabilize the skin, angle the needle appropriately, and deposit tiny aliquots. Mapping under animation. Injecting bands seen only at rest can miss the real driver. I ask patients to activate the muscle, then relax, then activate again. This movement mapping ensures the points align with the cords’ true path. Dosing cadence. Patients who speak publicly or sing often have unique demands on the neck. Starting more conservative and layering at two weeks protects function while still improving the look. Coordinated lower-face management. If the depressor anguli oris muscles over-pull the mouth corners, a tiny dose there may complement the neck result. If the chin is hyperactive and pebbled, mentalis botox can smooth it and reduce compensation patterns.
None of this should feel experimental. It is standard judgment in advanced cosmetic botox practice.
How to choose the right injector
Search “botox injector near me” and you will find a crowded field. Boil your selection process down to three essentials: training, experience with neck botox specifically, and communication. A licensed botox injector who can explain platysma anatomy in everyday language, show before and after photos of neck cases, and discuss risks without rushing is worth the drive. Titles vary — botox specialist, board-certified dermatologist, facial plastic surgeon, seasoned nurse injector under physician supervision — but the through-line is deep familiarity with the lower face and neck.
During your botox consultation, look for these green flags: they map your bands with you in the mirror, outline a starting unit range and why, and set a follow-up plan for adjustment. If Affordable Botox nearby you are steered into a one-size “neck package” without a physical assessment, that is a red flag.
When Botox is not enough
If you pinch the skin of your neck and lift, do you see a large fold that does not snap back? Significant skin redundancy often calls for energy tightening, thread lifting in select cases, or surgery. Platysma banding with heavy skin laxity can mask the improvement that botox provides. In these cases, we can still use small doses to reduce harsh cords, but I will be up front that the big change you imagine may require a different tool. That honesty saves you money and frustration.
Patients with substantial fat under the chin who ask about “botox for turkey neck” may get better mileage from fat reduction first. After debulking, neck botox can fine-tune. It is common to phase treatments over months, with an eye on both budget and recovery time.
Timelines, photos, and maintenance rhythm
Two-week check photos are invaluable. I take images at rest, in animation, and in three-quarter view. If we need more lift at the jawline, or if one side’s band remains more stubborn, the follow-up is the moment to tweak. After your second cycle, the dosing pattern usually stabilizes and we simply maintain. I encourage patients to schedule the next botox appointment before they fully lose effect, which keeps muscles from rebounding into old habits.
If you are combining areas — say, forehead lines, crow’s feet, and neck bands — we coordinate dosing so your expressions stay natural. A brow lift botox can subtly open the eyes, while neck botox calms cords. Done together, the face reads rested and harmonious rather than “done.”
FAQs I hear often
How soon can I work out? Light walking is fine the same day. Save vigorous exercise for the next morning.
Will I have downtime? Not in the typical sense. You might have a couple of pinpoint marks or a faint bruise. Most people feel comfortable resuming normal life immediately.
Is botox safe in the neck? With a certified botox injector who respects anatomy and dosing, yes. Adverse effects are uncommon and usually temporary.
What if I dislike the result? Botox wears off gradually over a few months. In the neck, over-relaxation is typically avoided by starting with conservative doses and reassessing at two weeks.
Can Botox fix sagging? It can improve the appearance of sagging when muscle pull is the culprit. Loose skin needs different tools. We will tell you candidly which is which.
Realistic expectations and the beauty of subtlety
The best neck botox results do not scream treatment. In photos, your neck looks smoother. In motion, the cords stop stealing attention. Friends might say you look rested, or that a new haircut suits you. The change is cumulative and graceful, not a shock. That is the power of small, well-placed doses over time.
If you are ready to explore neck botox, book botox with a provider who treats the lower face and neck routinely. Whether you search for “botox injection near me,” “botox treatment near me,” or ask for referrals, prioritize an experienced botox injector who can tailor units, place product at the correct depth, and plan around your goals. With the right hands, platysmal bands soften, the jawline breathes, and that quiet elegance down the neck returns.