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Q. Is Botox safe/effective to eliminate platysmal bands on a healthy & thin 32 year old in the hands of a competent doctor? I am 32 years old and for the last 4 years have noticed this unsightly platysmal band on my neck whenever I smile, laugh, eat, caugh, speak, etc. It ruins my pictures and makes me self conscious. I already see a triple board certified plastic surgeon for minimal fillers under my eyes but never had Botox injected. Is Botox a safe and effective way to eliminate this platysmal band? Is there any real risk of complications or of making it even slightly harder for me to breathe or swallow? A. In your photos it shows the medial band of the right platysmaplasty flexed or in spasm. The left band is visible but much less contracted. Like 20% of patients you have the muscles joined within the mandibular triangle resisting the sagging of under the “floor of mouth”. Yes, Botox or other similar injectible muscle relaxers can be used to weaken or relax the platysma muscle band. The injector must be skilled in the use of Botox to stay outside the muscle and not pass through where it may relax the muscles of the throat, and not allow the relaxation of the sling created by the muscles under the mouth. A more permanent option is a platysmaplasty which surgically joins the muscles down the neck, further feminizing its appearance by: