BACKGROUND. The use of botulinum toxin for facial rhytides has become
more popular. In the past, plastic surgery was the only choice for rej
uvenation of the aging neck. We discuss the cosmetic use of botulinum
toxin for the rejuvenation of the neck and review the anatomy. OBJECTI
VES. We will review the four age-related neck degeneration categories
and discuss how to inject botulinum A exotoxin into the platysmal neck
bands. RESULT. We will discuss how botulinum can tighten neck jowls,
eliminate horizontal neck rhytides, and improve skin laxity. CONCLUSIO
N. Botulinum A exotoxin is a safe, effective, alternative treatment fo
r rejuvenation of the aging neck and lower face. Patients are uniforml
y satisfied and complications are minimal. (C) 1998 by the American So
ciety for Dermatologic Surgery, Inc.