PLATYSMAL BAND TREATMENT: LET’S NOT FORGET THE NECK

The Importance of Neck Assessment in Facial Rejuvenation – A Clinical Case Series

Janet McIlroy RDH (GDC 5730)
Founder & Clinical Director, J Facial Aesthetics, Banbridge, Northern Ireland

Introduction

Facial rejuvenation commonly focuses on skin quality, dynamic rhytides, volume loss, and collagen stimulation. However, the neck is frequently overlooked despite its significant contribution to perceived ageing. These cases demonstrate why platysmal band assessment should form part of every comprehensive facial rejuvenation consultation.

Primary Case

A 63-year-old female patient presented seeking a fresher, more youthful appearance while maintaining natural facial expression. Following a comprehensive consultation, a phased treatment plan was developed, reflecting our clinic philosophy that facial rejuvenation is a journey rather than a single treatment.

Treatment commenced with upper-face botulinum toxin, followed by polynucleotide therapy to improve skin quality and tissue regeneration. Mid-face dermal filler restored age-related volume loss, while Sculptra® was incorporated as a collagen biostimulator to support long-term tissue quality and facial structure. Rather than treating only the signs of ageing visible today, our aim is to invest in the future health of the tissues through natural, progressive rejuvenation.

As facial quality, structure, and skin improved, the neck became increasingly noticeable as the next area demonstrating age-related change. Prominent platysmal bands created a visual imbalance between the rejuvenated face and neck.

Treatment

Following dynamic assessment, platysmal bands were treated with Azzalure®, administering 5 Speywood Units at four injection points approximately 1 cm apart along each visible platysmal band.

Outcome

Treatment produced a marked reduction in platysmal band prominence, improving neck contour, cervicomental definition, and harmony between the face and neck. The patient reported high satisfaction and felt the neck treatment completed her rejuvenation journey.

Figure 1. Primary Case – 63-Year-Old Female Patient

Clinical photographs demonstrating significant reduction in platysmal band prominence following treatment with Azzalure®.

Additional Clinical Cases

Two further female patients treated within our clinic demonstrated similar improvements in platysmal band prominence and neck contour, despite differing anatomy and degrees of muscle activity.

These cases reinforce the reproducibility of this treatment when patients are appropriately assessed and selected.

Discussion

Our treatment philosophy is based on phased, individualised care. Patients are educated that successful facial rejuvenation involves improving muscle activity, skin quality, facial support, collagen stimulation, and, where indicated, neck rejuvenation.

These cases demonstrate that once facial ageing has been addressed, the neck frequently becomes the next visible sign of ageing. If left untreated, prominent platysmal bands can detract from an otherwise successful result.

Conclusion

This case series demonstrates that platysmal band treatment provides meaningful improvement in neck contour, lower face-neck harmony, and overall facial rejuvenation.

While aesthetic practitioners routinely assess the forehead, eyes, cheeks, and jawline, these cases highlight an important clinical message: we must not forget the neck.

Incorporating neck assessment into every consultation allows practitioners to identify patients who may benefit from platysmal band treatment and achieve more balanced, natural-looking outcomes. Sometimes it is not about what additional treatment the face requires it is recognising when the neck needs to become part of the conversation.