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Chemodenervation of underlying muscles with botulinum A exotoxin (Botox) has been found useful for temporary treatment of dynamic wrinkles of the upper face. Surgery has been required for correction of platysmal bands, while skin resurfacing for treatment of horizontal neck creases has been suboptimal due to a high rate of complications. In this study, 1,500 patients with platysmal bands and horizontal neck creases who were not good candidates for surgery underwent Botox treatment.
Five to 10 units of Botox (5 units per 0.1 ml) were injected at 1- to 1.5-cm intervals along each platysmal band. Generally, 50 to 100 total units were injected, but up to 250 units were injected in a few cases. The best results were seen in the 80% of patients wi…