Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Platysma are the muscles of the neck. It is the most superficial muscle in the neck and face.

Platysma or Platysmal bands are two strips of muscle running down vertically on both sides of our neck. These bands are caused by contractions of platysma.

Platysma bands are one of the first signs of ‘neck ageing’. According to some theories, these bands develop due to the skin sagging. This is followed by loss of muscle tone. Tightening the skin and muscle are therefore the key components of the treatment strategy.

Are they dangerous?

They are not dangerous to life or health. They are quite common in many people. They may rise cosmetic concerns in some people and give mental stress. On the contrary they don’t pose risk to health. In this condition saggy skin can develop which may eventually result in a double chin, creases in the neck and a condition often referred to as ‘turkey neck’.

Platysma: Anatomy and Physiology

Platysma Muscle – It is the superficial muscle of the neck. It overlaps the sternocleidomastoid muscle. Superficially, it covers the front (anterior surface) of the neck. Wrinkling of the skin and a bowstring effect on either side of the neck is produced when platysma contracts.

This muscle arises from the fascia of the upper pectoralis major and deltoid muscle, cross the collar bone, proceed obliquely upward and medially along the side of the neck. As a result of this, the midline of the inferior part of the neck remains deficient of muscle cover. The muscle fibers from both sides mingle below and behind the mandibular symphysis while the fibers at the back of the muscle cross the lower jaw bone (mandible). Some of these fibers get inserted into the mandible and others into the skin and subcutaneous tissue.

Functions of Platysma – This muscle produces slight wrinkling of the surface of the skin of the neck in an oblique direction. These muscles also cause depression of the lower jaw and draws the lower lip and angle of the mouth in a frown.

Platysma Bands are caused due to the action of platysma muscle contracting through talking, eating and facial expression.

Clinical relevance – Strains, tears and atrophy may occur in these muscles just as in any other muscle. It is vulnerable to penetrating trauma. It needs to be cut through to access deeper structures when neck surgeries are conducted.

Wrinkly skin of the neck – is a condition caused by decrease in muscle tone. This would lead to thinning and shortening of muscle. It is the secondary complication of facial nerve palsy. It is also associated with normal ageing process.

Neck bands – With ageing, the neck bands above this muscle become most evident. Weightlifting or facelift procedures may aggravate this condition, a condition known as ‘turkey neck’ or platysma dyskinesia.

What causes these bands?

Neck Platysmal Bands is common and natural and is caused as part and parcel of aging process and thickening of the edges of neck muscles. Age, genetics and muscle activity are also counted amongst causes.

They can become more prominent for some individuals. As the person ages, the skin loses its elasticity naturally. The production of collagen which gives the skin the youthful firmness is also reduced. This, along with our genetics would cause the skin over the platysma to appear thinner and may sag. This makes the vertical bands of muscles more evident and obvious.

The skin overlying the platysma muscle becomes weak and sags due to loss of its elasticity. Laxity of muscle can also occur due to ageing process. This will cause the skin to droop. These bands also become visible sooner in people with thin skin. This suggests the role of genetics in the formation of platysma bands.

Strenuous exercises can also contribute to these bands by causing more tension and muscle activity in the neck. Therefore, one should, while doing exercises, be aware of neck tension and try to keep the neck muscles relaxed as far as possible.

Other factors involved in the causation of platysmal bands –

Muscle activity and natural ageing – Research studies showed that the combination of muscle activity and natural aging process can cause platysmal bands. This shows that it is not necessary that only ageing skin should cause platysma bands.

Surgery – In the studies it was found that about 76% of participants who had developed unilateral facial palsy following oto-neuro-surgical treatment had developed visible platysma bands. These bands were found to appear after 10 years after treatment and were found on the sides of the necks that were not paralyzed.

Exercise – If one notices carefully, the platysmal bands on the neck would stick out after he or she has lifted a weight and this happens due to the tension (of weight lifting) which strains his or her neck. Here we need to see that exercise is also a type of muscle activity. With passage of time these bands would become more and more visible. High intensity workouts might also affect the facial muscles. The chances of the skin overlying the muscle (platysma) getting stretched and sag would increase with more and more use of muscles of face and neck. One should know how much to exercise and workout. This awareness might help in keeping these bands at bay. It is wise to exercise / workout by looking into the mirror. This will keep our awareness focused on the neck muscles. This will also help one relax the neck muscles when as and when they get tensed.

Treatment of Platysma Bands

Since platysma band is not a condition of medical concern and since it doesn’t meddle with the health of those having bands. It is definitely of cosmetic importance and point of concern for many people. They may look seriously at diminishing these bands on their neck.

The below mentioned treatments might help in tackling platysmal bands.

Botox treatment – Research (2018) shows that botulinum toxin type A injection might help in reducing the appearance of platysmal bands. It does that by relaxing the muscles in the neck. Dr Paul Jarrod Frank (cosmetic dermatologist) tells that Botox can be used to get relieved of these bands which will cause unbunching of the jaw. This is called as Nefertiti lift.

It is a gentle and successful approach which is popularly used to reduce the appearance of platysmal bands. When injected carefully into the muscle, it releases the tension in the muscle caused by repetitive muscle contractions. This brings about relaxation and softening of the neck. This in turn improves the skin appearance caused due to ageing.

Neck Rejuvenation

• Dermal fillers – They are injectable treatments. They are used to plump up the skin overlying the bands wherein certain gel like substances like hyaluronic acid etc is used. Sometimes for better results, it is used along with botox.
• Skin boosters – They are highly effective at restoring lost volume to the lower face and neck regions where it is targeted. Hyaluronic acid is the main ingredient of the boosters. It is used by the body to retain water content in the skin and also to support elastin and collagen.

Neck Lift procedures (Platysmaplasty) – This would give dramatic results in the treatment of platysma bands. It is a surgical process and a definitive treatment. It can be considered when injectable medicines are not working well. It tightens the skin and muscles. This in turn leads to smooth neck and sharper jaw-line.

Lower facelift – The skin beneath the corners of your mouth are tightened. Excess skin is trimmed. Usually, it is performed by a plastic surgeon or an ENT (facial) plastic surgeon. It is effective though expensive. Bleeding, infection, scarring and nerve damage are some of the side effects of this surgery.

Platysmal band exercises help in strengthening the muscles of neck. It is also thought to reduce the possibility of formation of platysmal banding. But experts opine not to exercise this area. This is because the bands can be exacerbating by straining. Neck stretches on the other hand are gentler and can yield better results in comparison to platysmal band exercises.

The neck has thinner layer of skin in comparison to the face. Treatment ranges from administration of noninvasive cosmetic procedures to surgery.

Can Platysmal Bands be prevented?

It is very difficult to prevent platysmal bands. This is because they are caused by many factors including natural muscularity and genetics. Platysma muscle is involved in the muscle activities involving our eating, talking and facial expressions.

Ayurveda understanding of Platysmal Bands

Platysmal Bands can be said to be caused by severe aggravation of vata specifically in the region of neck and face. Vata affects the skin and muscles in the neck. Vata naturally aggravates in the old age and platysmal bands are also formed in this ‘vata favoring age’.

Excessive exercise is considered to be the main cause in the formation of platysmal bands. Ayurveda too has counted ati-vyayama i.e. excessive exercise as the chief cause for vata aggravation.

Vata balancing foods, activities, lifestyle changes, medicines and therapies should be the main strategies in the treatment of Platysmal Bands. Abhyanga, Nasya, Basti, Brimhana and Rasayana are the main components of the treatment of this condition and should be effectively brought into use as and when needed, individually or in combination.

Related Reading – ‘Platysmal Bands – Ayurveda Understanding’.