Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of cervical aging, specifically noting prominent vertical platysmal bands. Patient reports dissatisfaction with neck contour and submental definition. No history of prior neck surgery or cervical trauma. Patient denies dysphagia or neck pain.
Clinical Examination Findings
Physical examination reveals hyperkinetic platysma muscle with visible vertical banding upon animation (clenching teeth). Skin laxity noted in the submental and cervical regions. No evidence of submandibular gland ptosis or significant lipodystrophy. Bands are categorized as [Grade I/II/III] based on severity and resting tension.
Treatment Protocol
Proposed treatment plan: Targeted neuromodulator injection (e.g., OnabotulinumtoxinA) to the platysmal bands to reduce muscle hyperactivity. Alternatively, discuss surgical platysmaplasty for significant laxity. Post-procedure expectations: onset of effect within 3-7 days, duration of 3-4 months. Risks include transient dysphagia, neck weakness, or asymmetry.