Dear Dr. Seckel, I am 59 years old and have a sagging neck and some jowls forming. I have used Restylane for nasal labial folds and some lines in my chin and it works well. I am specifically looking for something for the neck and cords in the neck but hoped to avoid a face-lift. I tried Botox and it made swallowing difficult for several weeks. Any advice???? Carol, Norwalk, CT
Dear Carol,
Sounds as though you are very up to date in your knowledge of non-surgical facial rejuivenation. Botox can help neck cords, called platysmal bands, but you have to use a very small amount-I usually use 2.5 units in 2 different places on the cord, a total of 5 units each cord. Swallowing should not be affected. The fact you had swallowing difficulty suggests either too much Botox was used or it was injected too deeply. The Platysma muscle that causes the cord is above the muscles that control swallowing and should not be affected.
Skin tightening with the LuxIR (infrared machine-similar to Titan) can tighten the neck and jowls, but only about 30%. Of course a face lift or neck lift can tighten the neck and jaw line beautifully and eliminate the cords, but that is surgery.
The face lift and neck lift are going to give you the best result. Botox will give temporary improvement. The new skin tightening machines, LuxIR, Aluma with FACES, Titan, Refirme, and Thermage will give you 20-30% of what a face lift or neck lift can achieve. The choice is up to you.
I think your best option is to consult an experienced board certified plastic surgeon and get his/her advice.
Thank you for your question.
For more information on Botox, skin tightening, face lift and non-surgical facial rejuvenation read Save Your Face or contact me.
Boston, Massachusetts
Reply 9/27/06:
Dr Seckel, Thank you so much for your thoughtful and insightful answer. I am going to
another dermatologist and will discuss in detail the botox for the neck. I
did not tell you this, but when I had the botox injected, he also hit a
blood vessel (he said) and caused a bruise that swelled as large as a golf
ball for two to three days and then was black and blue for almost two weeks.
Does this indicate that the injection was too deep which could have affected
the difficulty in swallowing??
I also seem to have some hoarsness since this injection that I did not have
before. Carol