Abstract
BACKGROUND: Platysma prominence (PP) is a sign of aging in the lower face and neck characterized primarily by a blunting of the jawline and the presence of vertical banding along the anterior and posterior margins of the muscle on one or both sides of the neck. The aim of this review was to combine findings from the literature on topics relevant to PP with expert perspective to help guide clinical decision-making in assessment and treatment. METHODS: A review of the literature focusing on platysma muscle anatomy and function; PP signs, characteristics, causes, clinical severity, and aesthetic and psychosocial effects; and treatment options for PP was performed and summarized. Expert clinical perspectives of these findings elucidated from the authors' experience were used to develop considerations for the evaluation and treatment of PP. RESULTS: PP is an aesthetically undesirable condition that is bothersome to affected individuals and has negative effects on quality of life and psychological and emotional well-being. Knowledge of platysma muscle anatomy, proper patient assessment, and considerations in the use of onabotulinumtoxinA for the treatment of PP, including selection of the appropriate candidates and careful dosing and injection techniques, can produce consistent results with limited adverse events, potentially enhancing the patient's quality of life. CONCLUSIONS: PP is a bothersome condition with a detrimental impact on patient quality of life and psychological and emotional well-being. OnabotulinumtoxinA is a nonsurgical treatment option with a record of safe, consistent results in treating PP.