What it means for a patient
- Neck bands can be treated with injections in suitable patients.
- Results were best in patients with mild to moderate neck changes (types II and III), and close behind in types I and IV.
- How thick and how slack the platysma muscle was mattered most for success.
- Results come from physician and patient ratings in three practices. The abstract does not describe a control group or a standard scoring method.
Why this paper matters
It extended botulinum toxin treatment to the platysma bands of the aging neck. It introduced a four-type classification of the neck to guide dosing.
Overview
Botulinum A toxin was used for neuromuscular disorders and for lines caused by overactive muscles in the upper face. The authors extended its use to the aging neck, specifically to thick platysma muscle bands. They devised a classification (types I to IV) based on horizontal neck lines, platysma bands and skin laxity. It grades the degree of deformity and serves as a guide to suggested doses.
Findings
- 1500 patients were treated by three independent practices.
- The classification (types I to IV) is based on horizontal neck rhytids, platysma bands and skin laxity.
- Type II: mild horizontal neck lines, thin and mildly flaccid platysma muscle, mild skin laxity.
- Type III: moderate horizontal neck lines, thick and moderately flaccid platysma muscle, moderate skin laxity.
- Results correlated with the degree of age-related neck change.
- Type II and III patients were the most satisfied, followed closely by types I and IV.
- Most patients had results rated good or better by both the physician and the patient.
- The degree of muscle flaccidity and hypertrophy most influenced success rates.
- The authors state that anatomic variation in how the muscle is arranged was not the deciding factor.
- The abstract gives no doses and no duration of effect.
Terms
- Platysma: the thin sheet of muscle across the front of the neck.
- Platysma bands: vertical cords in the neck formed by the edges of the platysma.
- Botulinum A exotoxin: a toxin that temporarily relaxes the muscles it is injected into.
- Rhytids: wrinkles.
- Skin laxity: loose skin.
- Flaccidity: slackness of a muscle.
- Hypertrophy: enlargement of a muscle.
- Hyperkinetic: overactive.
- Dynamic rhytids: wrinkles caused by muscle movement.