Botulinum toxin-A (Botox ) has proven to be an effective agent in treating many aspects of the aging face, including glabellar lines and forehead creasing.

Based on encouraging results in these areas, physicians are taking the treatment south, treating the platysma bands of the neck with similar success.

As clinical associate professor of plastic surgery at Albert Einstein Medical College and in private practice in New York, Alan Matarasso, M.D., has seen the beneficial effects of botulinum toxin-A in the necks of hundreds of patients.

"About two-thirds of the poulation has prominent neck cords, or the turkey gobbler apperance," Dr. Matarasso said. "Treating these people with botulinum toxin-A offers them an option we never had before."

In a recently published study, Dr. Matarasso and his colleagues, Drs. Seth Matarasso, San Francisco, and Fred Brandt, Miami, tracked the experiences of 1,500 patients treated with botulinum toxin at three independent practices over a three-year period.

Eighty-four percent of the patients were women with a mean age of 45 years; the mean age of the male patients was 49 years. All patients were treated in an office setting with topical anesthesia and oral anxioletic, when necessary.

Indications for treatment included:

• banding, which did not warrant surgery, or a patient who was unwilling to undergo surgery;

• residual platysma bands after facialplastic surgery;

• horizontal neck lines associated with platysma bands; and

• patients with medical contraindications or those who were psychologically unprepared for surgery and were deemed nonsurgical candidates for facialplasty.

Contraindications included:

• inappropriate anatomy;

• pregnancy.