The Effect of Botulinum Toxin on the Platysma Muscle

Abstract

Even before physicians began to inject botulinum toxin A (BTXA) for the treatment of facial dynamic lines, we were already aware of the possibility of treating the platysma band and the transversal lines of the neck. There were few doctors claiming good results, but there were still questions about why, when, how, and in whom how to inject BTXA, as well as questions about the clinical results and complications of course. Now that we have being treating the lines of the neck through the platysmal bands for some time, with great emphasis at the contouring of the jaw line for the global facial rejuvenation, we can discuss treatment of the platysma muscle and analyze its dynamics, identification, and limits, and also have a better idea of how to manage the injection of BTXA in this area with good results. This article analyzes the pattern of a series of platysma muscle treatment to determine if there is a model that could be followed for the contouring of the face and neck by comparing the current knowledge about the behavior, position, and results of the BTXA injection sites based on the initial idea of treating the platysmal bands and the transversal cervical lines of the neck. We randomly selected 40 patients from our private clinic treated between 2006 and 2011 who had have botulinum toxin injections for the recontouring of the face to analyze if there was a pattern of injection to follow as a model for the treatment of the platysma. They were all female, as there were no males that had had any treatment for this indication in our files. These patients had received at least two treatments, resulting in a total of 90 treatments for the neck during 15 months, with the total dose injected per session varying from 10 to 70 units. We have made a retrospective evaluation of the pre- and post-treatment pictures, checking the effective clinical results after the treatment and making sure that the patient was included in the discussion. There was not any exact model of points, distribution, quantity, and constant pattern for the treatment of the platysma muscle for the contouring of the face. There were differences between the patients and in the same patient (e. g., different pattern from the right side and the left side). The clear knowledge of the muscular distribution through its dynamic action to work as a mimetic muscle that might change the facial lower contour is the key aspect for this treatment. © 2012 Springer Science+Business Media, LLC.