Botox® for Vertical and Horizontal Lines of the Neck

(Platysmal Bands + Necklace Lines)

 Photo Credit:  Allergan, Plc

Photo Credit:  Allergan, Plc



One of the earliest signs of aging can be the presence of prominent vertical lines in the neck.  These lines are caused by hypertrophy and laxity of the underlying platysmal muscle.  Because these lines can be seen even at the early stages of aging, they become quite concerning to patients.  Similarly, repetitive normal neck motion can cause horizontal laxity of the platysma muscle that cause the presence of the so called necklace lines.  Loss of collagen, elastin, and sun damage also lead to the presence of these lines.

For the vertical neck lines, small amounts of Botox® are injected into the muscle in 2cm increments to cause relaxation of the underlying platysma muscle.  This is done for each platysmal band.  Patients return in 2 weeks to insure that an adequate amount of correction was obtained.  If not, the treatment can be augmented with additional units to obtain the desired correction. On average, 12-14 units will be used per band during the first treatment.  

Necklace lines are treated by injecting small amounts of Botox® above and below the line.  This again leads to relaxation of the underlying platysmal muscle and decrease in the prominence of these lines.  Small superficial injections are used with 2 units per injection, and varying number of injection site based on the length of the line.  Average is 10-12 units for this treatment.

Number of treatments:

Similar to other Botox® treatments, the results typically last 3-4 months and patients should return for repeat treatments when they notice the lines returning. 

Appointment Time (may vary):

30 minutes for vertical bands, and 15 minute for horizontal lines. 


None.  Patients will notice slight redness and minimal pain at the injection sites that will quickly resolve. 

Ideal Candidate:

Patients with prominent vertical and/or horizontal neck lines that wish to see an improvement in the appearance of these lines.