Neck botox is a low-dose injection of botulinum toxin into the platysma, a thin muscle just under the skin that runs from the upper chest, along both sides of the neck, up over the jawbone. When the jawline is treated as well, it is known as the Nefertiti lift.

When this muscle contracts too strongly, vertical bands appear on the neck. It also pulls the lower face downward. Looser skin, extra fat and a small or receding chin can add to this over time, resulting in a blurred transition between face and neck and a more tired look.

Neck botox reduces the overactivity of the platysma, helping soften vertical bands and make the jawline look more defined. The active ingredient is the same as in regular botox; what differs is the area and how the dose is planned.

The Nefertiti lift, also called Nefertiti botox, is a form of neck botox that also treats the jawline. It is named after the Egyptian queen known for her sharp jawline and long neck.

In this technique, botox is injected both into the vertical neck bands and at specific points along the lower edge of the jawbone. The aim is to reduce the downward pull of the platysma on the face, so the jawline looks crisper and the lower face may feel slightly lifted. A Nefertiti lift does not replace a surgical facelift: its effect is milder and temporary, but it needs no recovery time. Like neck botox, it usually lasts 3–4 months.

It is most often considered for:

• Visible neck bands: vertical lines that show when you talk or clench your teeth.
• A softening jawline: a blurred face-neck transition caused by muscle pull.
• Early laxity: people who do not yet have marked skin sagging.

With advanced sagging or noticeable fat, botox alone is not enough. In that case, double chin treatment for fat under the chin, jawline filler for the jawline or neck and décolletage treatments for the skin may be part of the same plan.

The appointment starts with an examination. You are asked to clench your teeth or pull your lower lip down, so the doctor can see which bands appear and the direction of the muscle pull.

Stopping blood-thinning medicines and supplements such as aspirin, high-dose omega-3 and vitamin E for a few days beforehand, after checking with your doctor, helps reduce bruising. Avoiding alcohol the day before is also recommended.

1. The skin is cleansed and the injection points are marked.
2. Low doses of botox are injected along the marked bands, and under the jawline if needed, with very fine needles.
3. If chest lines are also being treated, the lower fibers of the platysma are injected as well.
4. The area is checked; small bumps usually fade quickly.

The treatment takes about 15–20 minutes, and you can return to your day straight away. The effect usually begins within 3–5 days and becomes clear in about two weeks. Precise dosing matters in the neck, so the treatment should be done by a doctor who knows neck anatomy well.

Beyond the neck, botox can also be used in the lower face and on the chest:

• Décolletage botox: relaxing the lower fibers of the platysma that extend onto the chest may help soften chest lines.
• Gummy smile botox: reduces the overactive muscles that show too much upper gum when you smile. Usually 2–5 points are treated, depending on the degree, around where the upper lip meets the side of the nose, the middle of the area between nose and lip, and the sides of the nasal bridge.
• Full-face botox: the forehead, frown lines and eye area are planned together with the lower face and neck.

For a natural result in the upper face, the low-dose, multi-point Hollywood Botox technique is often preferred. Teeth grinding or a lower face widened by muscle requires a different dose and is planned separately as masseter botox. For a slimmer, longer-looking neck and shoulder line, trap botox for the trapezius muscle can be planned alongside it.

Neck botox is temporary. The effect usually lasts 3–4 months and varies from person to person, depending on muscle strength, metabolism and lifestyle. With regular sessions, some people can space out treatments. When it wears off, the neck returns to how it was before; pausing does not make the bands worse.

After treatment, it is recommended that you:

• Don’t lie down or massage the area for the first 4 hours.
• Avoid intense exercise, alcohol, saunas and Turkish baths for 24 hours.
• Avoid tight clothing or pressure on the neck.

The most common side effects are mild redness, small bruises and brief tenderness at injection points. Rarely, especially with high doses, neck weakness or difficulty swallowing may occur. These effects are temporary, but contact your doctor if you notice them.