Botox for Sagging Necks

Conveniently located to serve Dallas and Plano, TX

There truly is no comparison to a facelift to achieve excellent reshaping and lifting for the aging neck. However, some individuals do not want or need a facelift. For these individuals Botox to treat a sagging neck may be the preferred method. Some individuals simply do not want a facelift or desire to have one maybe at a later date. Other individuals have very early neck sagging and want a non-invasive quick fix for their sagging neck. Botox can help individuals with varying degrees of neck sagging but is more ideal for the early neck sagging candidate perhaps in his or her 40s and early 50s.

First of all, Botox is not intended for extra fat in the neck or a double chin. Instead, Botox is specifically intended to manage the hanging platysma muscle. The platysma appears as two muscle bands that hang down vertically and has also been called a “turkey neck” or “turkey gobbler” deformity. As mentioned, for truly sagging necks, nothing compares to what a facelift can achieve. The best candidate is someone who has very early platysmal/neck sagging or even better someone who is very athletic and has these muscles show up only when they grimace or move their neck excessively.

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How does Botox work in the neck? Botox works by weakening the platysma muscle, especially the hanging edges, so that the continuous muscle in the face called the SMAS (superficial musculo-aponeurotic system) can provide counterpull and lift the neck upward. A basic trick with Botox anywhere in the face and neck region is to block one muscle to permit the other muscle to lift in the opposite direction. Think of a tug-of-war where one strong-muscled man pulls against a weakling on the other side. The strong-muscled man will win because of the net pull in his direction. Similarly, Botox in the neck weakens the platysma so that the facial SMAS can pull the neck upward.

How safe is Botox in the neck? Dr. Lam performs Botox neck injections several times each day and has been doing so for years. Although it has been reported, Dr. Lam has yet to encounter any issues with temporary speech or swallowing. In Dr. Lam’s hands, this procedure is very safe and effective and should be considered in the right individual who may not be ready for a facelift yet. A natural question is whether this area of the muscle provides any benefit to the individual that would be compromised by its weakening. The answer in short is no. There really is no problem of treating this muscle but only the benefit on ongoing neck improvement.

How long does it last? Like all facial Botox, consistency every three months provides long-term dividends. There are two benefits for consistent neck Botox. First, ongoing improvements in the results should become apparent since the muscle continues to weaken. Secondly, the results over time can last longer and longer and can serve to delay the need for a facelift in the individual with early neck aging. As mentioned, it is hard to reverse late neck aging and at that time the only real benefit will come from a face/neck lift.

For more information on Botox for sagging necks, please watch Dr. Lam’s virtual consultation

Your Botox for Sagging Necks will be performed by Dr. Lam's surgery center located in Plano, TX.


What should I expect with this treatment?

The treatment is super fast and involves injecting the edge of the platysma muscle. This is the muscle that can hang vertically in the center of the neck. There are several key things to understand. When there is actually sagging of the neck bands beyond an early sagging, Botox in the neck does very little to reverse the situation. Only a consultation with Dr. Lam will give you a realistic understanding of the pros and cons in your specific situation. Dr. Lam always emphasizes that typically you will not see a difference after one treatment but that repeated treatments over time should continue to reverse the sagging of the neck, again so long as it is early in the process of sagging. It also has an amazing preventative aspect where repeated dosing continues to maintain the neck and over time requires less treatment.

How does this procedure actually work?

The way that Botox for a sagging neck works is by weakening the platysma muscle, which is a depressor that pulls the neck down. The platysma is in continuity with the SMAS or the muscle that Dr. Lam usually pulls upwards on during a facelift. Accordingly, the weaker the depressor muscle (platysma) becomes over time, the more that the other muscle (SMAS) can pull upwards. Think of a tug-of-war between two men. If one continues to weaken one man, then the other man will pull toward himself more. The weaker man is the platysma so that over time the neck is being pulled upwards (SMAS).

Is it painful and is there recovery time?

No, the way that Dr. Lam performs this procedure is close to zero pain due to his unique shaking method. It takes about 10-15 seconds to perform and is incredibly comfortable even for patients with needlephobia. There is virtually no recovery time, as bruising is very uncommon (albeit still possible) and minimal if does occur. There is really no swelling beyond a few minutes after the procedure.

How often should I treat my neck with Botox?

In order to truly see an improvement, Dr. Lam always emphasizes that it is better to try to do this procedure every 3 months for at least a year and then oftentimes can be done less often thereafter. He will guide you on a specific regimen when he sees you.

Will this method of Botox for the neck help with skin texture improvement?

No, this won’t. However, he uses a method known as Mesotox, or MesoBotox, (PLEASE LINK) that does help with the skin quality including pores, texture, tone, and oftentimes even discoloration in the neck, decolletage, and chest area.

Does this help with dynamic banding?

Yes, the other reason to treat plastymal bands is to manage their presence only when you move your neck excessively. Whereas sagging neck bands is usually treated in the middle-aged individual, dynamic bands can be treated in almost any age but is usually observed more commonly in younger patients who are more athletic.

When should I consider a facelift?

As mentioned, this method really serves as a good preventative for people trying to avoid or delay a facelift but really only works well in very early neck banding. Once there is notable sagging of the neck, this procedure does very little and a facelift should be considered.

Will Botox help reduce any bulk in my neck?

No, it really will not. The best method is to perform a facelift and deep neck lift. There are very few non-surgical methods that can safely and effectively reduce the bulkiness of the neck.
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His technique is great and i never have pain when he does my fillers and botox.

Botox: Sagging Necks/Platysma

For a consultation with Dr. Lam regarding whether Botox for sagging necks would work for you, please email us at or call 972.312.8188.

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