Botox neck bands: platysma bands, why and how?

The neck is one of the eleven areas of our guide to botulinum toxin, area by area. This page is about platysma bands: where they come from, what studies show, why treatment is approved in the United States but not in France, and which precautions apply to this area. It does not replace a consultation.

Why is the neck treated?

The platysma is a very thin, sheet-like muscle that spreads under the skin of the neck from the jaw. When it contracts, it can form vertical bands, sometimes called "neck cords", connecting the jaw and the neck¹. Researchers use the term "platysma prominence" for all the visible effects of its contraction: neck bands and a less defined jawline².

Botulinum toxin temporarily relaxes the platysma fibres injected just under the skin, which softens these bands². An Italian expert consensus published in 2026 identifies three indications for this muscle: platysma bands, jawline contour and skin texture³. Platysma bands already appeared in an international consensus from 2010, written by an expert board convened around one manufacturer’s product⁴.

What the toxin does not do: it does not treat excess skin on the neck or fat under the chin, and it does not treat horizontal lines related to skin quality in the same way as muscle bands.

When is the toxin used?

In France, there are no official criteria, since no label provides for this area. In the United States, the FDA approval covers the temporary improvement in the appearance of moderate to severe vertical bands connecting the jaw and neck, in adults¹. The phase 3 trial that supported it involved adults with moderate to severe platysma prominence².

The contraindications in the labels apply whatever the area: allergy to the toxin or to a component of the product, a generalised disorder of the muscles and of the junction between nerve and muscle (myasthenia gravis, Lambert-Eaton syndrome), an infection at the injection site^5,6. For the neck, one precaution matters particularly: the labels advise against injection in people with a history of swallowing problems or aspiration (food or liquid going down the wrong way)^5,6. Pregnancy and breastfeeding are also situations in which treatment is not recommended^5,6.

Which toxin for the neck?

Approved in the United States for neck (platysma) bands since October 2024 (a type A product), not in France.

The type A toxins approved for aesthetic use in France cover frown lines and, depending on the product, crow’s feet and forehead lines⁶. None provides for the neck. The short-acting botulinum toxin (serotype E) is approved for frown lines only, in the European Union and in Canada^5,7. In France, any injection in this area is therefore off-label.

The situation is different in the United States: in October 2024, the FDA approved a type A toxin for moderate to severe platysma bands in adults¹. This approval does not apply in France.

Is it right for me?

Your doctor will look at your neck at rest and when you clench your teeth, the quality of your skin and your jawline. They will ask about any difficulty swallowing, choking episodes or breathing problems, which call for caution^5,6. They will take into account your medical history, your treatments and any pregnancy plans.

The neighbouring areas are covered on the pages about the masseter and jaw and the orange peel chin.

Questions to ask your doctor: is this treatment off-label in France? Are my bands caused by the muscle? Which signs should make me seek urgent care? How long should the effect last, in your experience?

Onset and duration

No French label gives an onset or duration for this area. In the phase 3 trial, the main effect was assessed on day 14: 32.3% of treated people had reached a minimal or mild grade with an improvement of at least two grades, compared with 1.9% on placebo². Participants were followed for 120 days after a single session²; the abstract does not state how long the effect lasted.

How these timelines work in general is explained on the page about how long botulinum toxin takes to work.

What are the risks in this area?

The neck is close to the muscles used for swallowing and speaking. All the labels point out that the effect of the toxin can, in some cases, be seen beyond the injection site, with muscle weakness, swallowing or speech problems, or even breathing difficulties^5,6. These problems require immediate medical attention⁵.

In the phase 3 trial on neck bands, side effects were as frequent with the toxin as with placebo, and no swallowing problems or muscle weakness were reported². This trial evaluated a single session, and several of its authors were employees of or consultants to the manufacturer².

If you feel any discomfort after a neck injection, the page on the neck after an injection explains how to recognise a stiff neck or difficulty swallowing, and when to seek urgent care.