Aging skin can lead to the formation of platysmal bands, those vertical lines or ridges that appear on the neck, which are a common concern for many. The neck and décolletage areas are susceptible to wrinkles and other signs of aging, much like the face. While often associated with aging, these bands can also present in younger individuals due to genetic predisposition or unique muscle anatomy. Platysmal bands, also known as neck lines or turkey neck, are a common sign of aging that can appear as deep-set horizontal creases across the neck area. Sometimes neck lines are more noticeable after significant weight loss. One of the more common signs of aging or massive weight loss will be the appearance of neck banding. In essence, two distinct vertical bands can be seen leading down the neck from the bottom of the chin, sometimes all the way down to the collar bone. Although this is most often associated with the effects of facial aging, neck bands can also occur following dramatic weight loss as the face and neck lose fullness. Regardless of age, individuals often look for solutions to restore a smooth, youthful neck.
What are Vertical Neck Lines?
Neck lines are horizontal or vertical lines that appear on the neck as a natural part of the aging process. Neck lines, (AKA platysmal bands, or ‘turkey neck’) are a very common, less-than-desirable sign of aging characterized by deep-set horizontal creases across the neck area. Platysmal bands are two strips of muscle that run vertically down both sides of your neck. They’re caused by contractions of the platysma, the most superficial muscle layer in the face and neck.
Causes of Vertical Neck Lines
The platysma is a thin, sheet-like muscle in the neck that extends from the chest up to the jawline. The delicate neck skin is more susceptible to the formation of platysmal bands due to its thinner composition and vulnerability. Over time or due to certain conditions, this muscle can separate or tighten unevenly, creating visible vertical bands on the neck. With age, these muscles can naturally become stretched and appear droopy. This starts to occur, for most people, in their early fifties. The platysma bands are the two muscles on either side of the neck. If you grimace through clenched teeth, you should be able to feel these muscles. Unlike other muscles, which are attached to ligaments and bones, the platysma muscles are free floating and will pull forward as they contract.
Several factors contribute to the development of vertical neck lines:
Aging: As we age, our skin naturally loses collagen and elastin, two essential proteins that provide structure and support. The skin’s loss of elasticity causes the skin overlying the platysma to weaken and sag. Additionally, the platysma muscle becomes lax with age, causing the skin to droop. Your skin naturally loses elasticity as you get older. “Gravity takes over, and the skin on your cheeks starts to drift down,” explains Dr. Newman. “Your cheek skin then pools underneath your jawline and in your neck.” The skin on the neck is thinner and more delicate compared to other areas of the body, making it particularly susceptible to wrinkles and sagging. As we age, the production of collagen and elastin decreases, leading to a loss of skin elasticity and firmness which is the main cause of neck wrinkles and part of the way our face naturally ages.
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Genetics: While neck bands generally become more apparent as a natural part of aging, genetics and lifestyle can play a role as well. “I hear, ‘I have my mother’s neck’ or ‘I have my father’s jaw,’ all the time,” Dr. Newman says. “Your inherited bone structure or anatomy affects whether you carry extra neck tissue or are prone to collect excess fat around your neck.” Genes Over time, these folds can become visible even at rest. In other words, lax muscles on either side of the neck fall forward, causing loose bands composed of skin and underlying muscle to bulge.
Weight Fluctuations: Weight gain can cause extra fat to collect around your neck. Sometimes neck lines are more noticeable after significant weight loss. Although this is most often associated with the effects of facial aging, neck bands can also occur following dramatic weight loss as the face and neck lose fullness.
Lifestyle Factors: Environmental toxins, smoking, sun damage and a poor diet can all eat affect your skin’s elasticity, too. More recently, neck lines have been linked to the increased use of mobile devices that have us bending our heads down and folding our neck skin in the process. UV rays are a primary cause of premature aging. Apply a broad-spectrum SPF 30 or higher to your neck every day, even when it’s cloudy. Drink plenty of water throughout the day to keep your skin plump and hydrated from within. Eat a diet rich in antioxidants, omega-3 fatty acids, and vitamins C and E.
Muscle Activity: Experts thought aging skin was the top cause of platysmal bands. But a small 2017 study debunked this. Researchers looked at 25 participants with definitive, unilateral, facial palsy following otoneurosurgical (ear and brain condition) treatment. After 10 years, 76 percent of the participants had visible platysma bands on the side of their necks that weren’t paralyzed. As a result, researchers concluded that muscle activity, combined with the natural aging process, caused prominent platysmal bands.
Tech Neck: Prolonged device usage can lead to ‘tech neck’ and the development of ‘tech neck lines,’ which are horizontal wrinkles on the neck. This condition is becoming increasingly prevalent due to modern lifestyles characterized by frequent screen time. Poor posture and extended periods of looking down at screens can exacerbate platysmal bands. The ache or soreness caused by repetitively looking down at your phone can also cause necklines. As all wrinkles are caused by repeated movements, the constant motion of looking down can cause your neck to crease, turning into permanent wrinkles. Try to be mindful of how you are holding your phone and raise it in front of your face to look straightforward. Be aware of how often you’re looking down at your devices, even if you’re young.
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Prevention
Preventing neck lines involves adopting a comprehensive skincare routine and making lifestyle changes to protect the skin from damage.
Sun Protection: Regular use of sunscreen can slow the signs of skin aging. Wear sunscreen Regular use of sunscreen can slow the signs of skin aging. Try to wear at least SPF 30 on your face every day and reapply every 2-3 hours. UV rays are a primary cause of premature aging. Apply a broad-spectrum SPF 30 or higher to your neck every day, even when it’s cloudy.
Hydration: Drink plenty of water throughout the day to keep your skin plump and hydrated from within. Staying hydrated to maintain skin moisture and elasticity.
Healthy Diet: Eat a diet rich in antioxidants, omega-3 fatty acids, and vitamins C and E.
Avoid Smoking: Don’t Smoke Smoking is one of the most leading causes of premature aging. Tobacco smoke damages collagen and nicotine causes blood vessels to restrict. Talk to your healthcare provider about a program to help you quit.
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Good Posture: “Tech neck” is real. Be aware of how often you’re looking down at your devices, even if you’re young.
Skincare Routine: Don’t stop at your jawline! Apply your facial serums, moisturizers, and treatments to your neck and décolletage.
Non-Surgical Treatment Options
Fortunately, there are many non-surgical, minimally invasive treatments available to smooth lines on your neck. Non-invasive treatments offer effective solutions for reducing neck lines without the need for surgery. Non-invasive neck wrinkle treatment is much quicker than surgery with virtually no downtime in most instances.
Botox or Neuromodulator Injections: Botox can temporarily relax the platysma muscle, softening the appearance of neck bands. This treatment is quick, performed in-office, and requires no downtime. Results typically last three to four months, making it a popular choice for those seeking minimal commitment. Botox Injectables block the nerves’ chemical signals that cause our muscles to contract. When injected into the neck’s vertical bands, Botox can help relax the dynamic muscles, reduce neck lines, and prevent new ones from forming-for an overall smoother, more youthful-looking neck. Results typically last 4-6 months and can be repeated as needed. Many notice their results within a day or two of treatment, but it can take several weeks to see full results. BOTOX® Cosmetic is a good non-surgical option to treat the appearance of mild to moderate neck bands, as it will help to loosen the platysma muscles, which are often contracted and tight in patients with neck bands. Dr. Pin will inject the BOTOX® Cosmetic just under the skin in the area of the neck banding.
Dermal Fillers: Dermal fillers are an effective neck wrinkle treatment as they are injected into your neck to smooth our lines and wrinkles. Hyaluronic acid is the active ingredient which can be found in our skin, muscles, and tendons. While Botox is ineffective, soft tissue fillers may be of great help. By injecting a very small dose of hyaluronic acid filler along the horizontal neck lines, creases can be plumped and filled. The smooth, youthful-looking results resulting from this procedure can last for up to a year. Many notice their results immediately after treatment, while others notice them within a day or two, but it can take several weeks for full integration. Dermal Fillers: Filler helps lines by adding volume to the neck area, which smooths out the skin and reduces the appearance of lines and wrinkles. When used for neck bands, dermal fillers are typically applied to restore volume and smooth out the wrinkles and creases caused by sagging skin. During the procedure, the chosen dermal filler is injected strategically into the areas affected by neck bands. The filler plumps up the skin, effectively filling in the creases and wrinkles associated with the bands. Dermal fillers can also enhance overall skin quality, improve skin texture, and restore lost volume in the neck. The results from dermal filler treatments for neck bands are typically immediate and can last several months to a year, depending on the specific filler used and individual factors.
Thread Lifts: For those seeking a non-invasive lifting effect, thread lifts can offer an immediate improvement. Threads are inserted under the skin to physically lift and support sagging areas while stimulating collagen production for long-term benefits.
PRP Therapy (Platelet-Rich Plasma): PRP uses your body’s natural growth factors to rejuvenate the skin and stimulate collagen production. When combined with microneedling, it can improve skin texture and firmness, addressing mild laxity around the neck.
Low-Intensity Extracorporeal Shock Wave Therapy (LI-ESWT): This innovative treatment stimulates collagen and elastin production, enhancing skin tone and elasticity.
Laser Skin Resurfacing: Laser skin resurfacing uses heat to rejuvenate your skin. The FotoFacial procedure uses radiofrequency, infrared, and intense pulsed light (IPL) energy to address various skin problems, including discolouration and fine lines on the face, neck, chest, and hands. Most patients require about 5 treatments to achieve desired results, performed once every 3 weeks. Patients usually start to notice the results of their FotoFacial about 1 week after their first treatment, and they get closer to their desired outcome with each treatment.
Ultherapy: Ultherapy uses focused ultrasound to lift and tighten your skin. Ultherapy®.
Microneedling: Microneedling involves using tiny needles to create micro-injuries in the skin, stimulating collagen production and improving the appearance of wrinkles and fine lines. Microneedling uses tiny needles to stimulate your skin to repair itself. Microneedling: Microneedling helps tech neck lines by creating micro-injuries in the skin, which stimulates collagen and elastin production.
Radiofrequency Microneedling: Radiofrequency microneedling uses radiofrequency energy to help collagen grow and tighten your skin. Morpheus 8 is a minimally invasive treatment that combines microneedling with radiofrequency energy to tighten the skin and improve neck contour. It’s essentially a form of enhanced microneedling which promotes collagen growth by encouraging self-healing via the pinpricks and radiofrequency treatment. Morpheus8 RF Microneedling: Morpheus helps neck lines by combining microneedling with radiofrequency energy.
Radiofrequency: Radiofrequency treatments use energy waves to heat the deeper layers of the skin, stimulating collagen production.
IPL (Intense Pulsed Light): A gentle, customizable treatment that’s perfect for improving sun damage, age spots, and redness.
Thermage®: Uses radiofrequency energy to tighten lax skin and boost collagen production, keeping the skin surface cool for comfort.
ThermiTight: A minimally invasive procedure that delivers RF energy under the skin for smoother, firmer results.
Clear + Brilliant: Clear + Brilliant helps by using fractional laser technology to exfoliate the outer layer of skin and stimulate collagen production.
Deoxycholic Acid (Kybella®): Kybella is an FDA-approved treatment to dissolve submental fat, creating a more defined neck profile. Injections help dissolve neck fat.
Fat Freezing and Nonsurgical Body Sculpting: Such as CoolSculpting®, and devices that use laser, radiofrequency or ultrasound energy to destroy fat cells.
Customized Skin Care: A good at-home regimen, including medical-grade skincare products, can support treatment results and slow the progression of skin laxity. An anti-aging skin care routine, including neck creams and lotions can help minimize collagen loss and tighten your skin.
Vitamin C Serum: Vitamin C has antioxidant attributes that are excellent for the skin. Studies show that the vitamin can reverse some of the damage caused by UV rays and other environmental factors such as free radicals.
Apply a Retinoid Cream: Retinoids are one of the most celebrated anti-aging ingredients in skincare. It’s best to start with a small amount every few days, as the ingredient can cause extreme dryness and peeling when you add it to your skincare routine.
Moisturize: Many people remember to moisturize their face, but it’s easy to forget about the neck. Some moisturizing products are made specifically for the neck. Hydrating the skin will help it look plump, so wrinkles are less visible, and it can also help prevent future creases from forming.
Surgical Treatment Options
For individuals with more pronounced platysmal bands or significant skin laxity, surgery may be the most effective option. Surgery offers a more long lasting alternative to non-invasive treatments for neck lines. The procedures are more complex, usually have a longer downtime, and a lengthier recovery period which are drawbacks.
Neck Lift (Platysmaplasty): A neck lift or platysmaplasty can provide long-lasting results by physically tightening the muscle and removing excess skin. A neck lift, or lower rhytidectomy, is a surgical procedure that involves tightening the skin and underlying muscles of the neck to improve contour and reduce wrinkles. It can be combined with other procedures such as a facelift of liposuction to enhance the overall effect. Platysmaplasty is a surgical procedure that focuses specifically on correcting neck bands. The surgeon makes small incisions under the chin or behind the ears to access and tighten the neck muscles. The platysma muscles are often repositioned or sutured together to create a smoother appearance. Platysmaplasty can be performed as a standalone procedure or in combination with a neck lift for comprehensive neck rejuvenation.
Facelift (Rhytidectomy): While a lower facelift primarily targets sagging skin, jowls, and wrinkles in the lower face, it can also provide significant improvement in the appearance of neck bands and can be performed during a platysmaplasty for a full facial rejuvenation. During the surgery, the surgeon can access and tighten the platysma muscle. The surgeon may make incisions either in front of or behind the ears and use sutures to tighten and reposition the muscles, reducing the visibility of the bands. Skin is trimmed or lifted, and the remaining skin is repositioned for a smoother and more youthful appearance.
Liposuction: For patients that have excess fat in the neck area, a liposuction procedure may be a solution. In this procedure, Dr. Pin will make a series of small incisions around the neck. He will then use a thin metal tube, called a cannula, to vacuum out the fat.
Exercise
While certain exercises that target the muscles in the neck, such as the platysma muscle, may provide some benefits. These exercises can potentially help improve muscle definition and tighten the neck area, which might indirectly contribute to a reduction in the prominence of neck bands. Daily neck exercises can strengthen neck muscles, which may help improve your neck’s appearance. For ideas on moves you can try, ask a dermatologist. But the opposite happens: “We don’t typically recommend exercising this area, as the bands can be exacerbating by straining such as grimacing when lifting weights,” Goldman says. You may have better results with neck stretches, which are gentler. “There are different stretches that promote a gentle toning of the muscle that may help,” Goldman says.
Important Considerations
When dealing with platysmal bands, it’s essential to consult with a practitioner experienced in neck and facial aesthetics. The ideal candidate for Botox or dermal fillers is someone whose necklines are not deep and grooved, is at normal weight, and has little fat underneath the jawline. Ultimately, the best way to determine your neck line removal procedure’s final cost is to schedule a consultation. Determining the cause of your neck lines will help us better recommend a custom treatment solution that addresses your unique case. Whether opting for non-surgical or surgical option, it is important to have realistic expectations and to follow pre- and post-treatment instructions carefully.