Walk into any aesthetic clinic on a weekday afternoon and you will hear at least one person asking about a “Nefertiti lift.” The name hints at its aim: a cleaner jawline, a smoother neck, and that lifted contour associated with youthful faces in profile. The technique uses targeted botox injections to relax specific depressor muscles in the lower face and neck, creating a more defined jaw and a lighter pull on the corners of the mouth. It is not a facelift, and it does not replace loose skin removal, yet in the right candidate it delivers a visible refresh with minimal downtime.
I have performed and overseen hundreds of lower face botox treatments across different ages and face types. Some patients want a sharper jawline without filler. Others come in after weight loss or post-pregnancy, when a once-crisp neck has softened. A few are anxious about looking “frozen.” They bring their worries, a handful of botox reviews they saw online, and two or three photos of celebrities saved on their phones. The best outcomes come from aligning the technique to the anatomy in front of you, not to a template.
What the Nefertiti Lift Actually Does
The Nefertiti lift is a pattern of botox injections along the jawline and into the vertical neck bands to reduce downward pull from the platysma and other depressor muscles like the depressor anguli oris and depressor labii inferioris. By decreasing tension in these areas, the upper elevator muscles of the midface and lower face work unopposed, so the jawline appears smoother and the corners of the mouth sit more neutral or slightly lifted. Think of it as releasing the tug-of-war on the lower face.
We are not changing bone structure or removing fat. We are quieting the muscles that drag tissue downward and inward. This is why realistic expectations matter. If your main concern is heavy jowls from significant skin laxity or prominent submental fat, botox alone will not solve it. But if you have early blunting of the mandibular angle, visible platysmal bands when you clench or grimace, or corners of the mouth that pull down into a perpetual frown, the lift can be a smart, non-surgical strategy.
How Botox Works in This Area
Botox is a neuromodulator that temporarily blocks acetylcholine release at the neuromuscular junction. The effect is dose dependent and localized to the injection sites when placed correctly. For the jawline and neck, the principle is selective weakening. The platysma is a thin, sheetlike muscle spanning the lower face and anterior neck. Overactive platysma fibers, especially in expressive or athletic individuals, can pull the jawline down and forward. When botox reduces that activity, the jaw and neck look more relaxed and straightened.
Different brands of botulinum toxin type A exist, including Botox, Dysport, Xeomin, and Jeuveau. They behave similarly in experienced hands with dosing conversions, diffusion characteristics, and unit costs that vary. Some practitioners have a brand they prefer for this area based on feel and spread. What matters most is correct placement, appropriate units, and understanding of neck anatomy, including the marginal mandibular nerve and the border of the mandible where precise depth and spacing avoid complications.
Who Is a Good Candidate
You might be a strong candidate if you clench your teeth and notice vertical neck bands popping out, if your jawline looks crisper when you gently lift your skin upward with your fingertips, or if the corners of your mouth rest in a downward position even when you are neutral. Younger candidates, often in their late 20s to early 40s, tend to have better skin elastic recoil, so botox results along the jaw and neck look especially clean. Men seeking a calmer neck profile after weightlifting or masseter hypertrophy treatment can also benefit, although dosing typically requires adjustment due to stronger muscles.
I screen for two red flags. First, significant skin laxity and submental fat that would be better addressed with skin tightening, liposuction, or a surgical lift. Second, a history of dysphagia or neck weakness where aggressive platysma dosing could make swallowing or head flexion uncomfortable. This does not rule out treatment, but it does influence the plan. If you have TMJ symptoms or bruxism and already receive botox for masseter reduction, we tailor unit distribution to avoid excessive lower face weakening.
The Treatment Visit, Step by Step
After a botox consultation, photos are taken with a neutral expression and with contraction, which means clenching the jaw and projecting the lower Click here for more lip to map platysma bands. I like to mark the jawline from the gonial angle to the chin, then draw vertical guidelines over each visible band. Skin is cleansed and, if desired, a topical anesthetic is applied, though most patients find neck injections tolerable without numbing.
The injection pattern varies by face, but it generally includes small aliquots along the mandibular border, just inferior to the skin, spaced roughly 1 cm apart, and a series along the vertical bands down the neck, avoiding the thyroid area and staying lateral enough to prevent midline spread. The aim is a feathered grid, not a single bolus. With careful technique, bruising stays minimal. I ask patients to activate their platysma during the session so I can confirm placement. The botox procedure itself takes 10 to 20 minutes once mapped.
Units, Dosing, and Customization
There is no single correct dose. I will give ranges to ground expectations. For the jawline component, 8 to 20 units per side is common, spread across multiple points. For the neck bands, totals can range from 20 to 60 units, depending on how many bands and how strong they are. Some athletic men with thick platysma need more. Baby botox approaches use lower units with more frequent touch-ups for a lighter, more natural result.
Ask your botox provider about their plan for your anatomy. A seasoned botox specialist can explain which muscles they are targeting and why. If you are on the cautious side or a first time botox patient, a conservative initial dose with a scheduled two-week review allows fine-tuning. That approach prevents the over-relaxation that can make the lower face feel weak or cause a slight smile asymmetry when depressor muscles are quieted too much.
What It Feels Like and What to Expect
Most patients describe a series of tiny pinches. The neck is sensitive but not deeply uncomfortable. If you worry about needles, ask to use a vibrating distraction device or ice. Immediate bumps at injection points flatten within 15 to 30 minutes. Makeup can be applied later the same day as long as the skin is clean and treated gently.
Botox does not work immediately. When does botox start working in the neck and jaw? Expect early changes around day 3 to 5, with peak effect at day 10 to 14. The jawline often looks crisper by the second week, and neck bands smooth when you attempt to activate them. The botox healing process is minimal. You can return to work right away, though I recommend avoiding strenuous workouts, saunas, or deep tissue neck massage for 24 hours. Things to avoid after botox also include lying face-down for spa treatments that day and wearing tight straps or helmets that compress injection sites in the first few hours.
Longevity and Maintenance
How long does botox last in the neck and jaw? The typical range is 3 to 4 months. Some people, especially those who metabolize neuromodulators quickly or who have very strong muscles, notice softening at 8 to 10 weeks and schedule earlier maintenance. Others hold for 5 months. How often to get botox becomes an individual rhythm. If you prefer steady, natural results, plan for 3 to 4 sessions a year rather than letting the full effect wear off between visits.
Over time, repeated treatment can produce better baseline relaxation, so units may be adjusted downward. I prefer the lightest effective dose that maintains the aesthetic goal. If a patient begins masseter botox for jaw clenching or aesthetically slimmer lower face contours, we rethink balance across the lower face. Too much muscle relaxation in one zone can make another area look disproportionate. Coordination matters.
Before and After: What Changes Are Realistic
When you look at botox before and after photos for a Nefertiti lift, pay attention to three landmarks: the angle at the back of the jaw, the straightness along the mandibular border, and the visibility of vertical neck bands in animation. A good result shows a more even jawline, corners of the mouth that no longer turn down with every expression, and a neck that looks less stringy when you clench.
You will not see skin removed or jowls erased if those originate from heavy fat pads and loose dermis. You can, however, see a lighter, more youthful tension pattern. I have had patients in their early 30s who looked “tired” in profile due to tight platysmal bands that stood out in photos. Two weeks after a tailored lift, their profile softened and their selfies improved, without anyone guessing why. On the other end, a woman in her mid-50s with mild laxity and early jowls gained enough jawline definition from the Nefertiti approach that she postponed surgical plans for a year. She paired it with a modest volume of chin filler later, which enhanced her results without overfilling.
Side Effects, Risks, and How to Avoid Problems
Any botox injections carry potential side effects: pinpoint bruises, swelling that resolves same day or next, and tenderness at injection points. In the neck and jaw, there are a few specific concerns to discuss. If botox spreads too deeply or broadly into the platysma, a small number of patients report neck fatigue when doing sit-ups or lifting their head. Very rarely, if doses are placed too close to the swallowing musculature or at incorrect depth, transient dysphagia can occur. Careful mapping and conservative dosing virtually eliminate this in experienced hands.
Smile asymmetry can happen if the depressor anguli oris receives uneven dosing, which can pull one corner down or relax one side more than the other. Your injector should ask you to animate and check symmetry during treatment. If it occurs, small balancing doses in a follow-up visit usually correct it. Headache, a known short-lived reaction to botox for forehead treatments, is uncommon with neck work but possible.
I tell patients the low-probability but real risks so there are no surprises. Does botox hurt? Briefly, yes, but it is manageable. Is botox safe? When performed by a trained botox doctor, nurse injector, or dermatologist who understands the anatomy, the safety profile is strong. Can botox go wrong? It can, in inexperienced hands or with poor candidate selection. Choose your botox provider with the same care you would use for any medical procedure.
Cost, Pricing Variables, and Value
Botox price depends on region, brand, and whether the clinic charges per unit or per area. Per unit cost can range widely, often from 10 to 20 dollars per unit in the United States, sometimes higher in major cities. The total for a Nefertiti lift varies because units vary; a conservative session might total 40 to 60 units, while a more robust treatment with multiple bands can exceed that. Some clinics offer botox packages, promotions, or seasonal botox specials. New patient botox deals can make sense if they do not pressure you into more units than you need.
Be cautious with deep botox discounts posted online. Cheaper is not better if it leads to underdosing, over-diffusion from poor technique, or non-medical environments. If you search for botox near me, refine your search to clinics with consistent botox reviews, clear photos of their work, and transparency about follow-up. The value of a careful consultation and proper dosing far outweighs a small per unit discount.
How It Compares to Other Treatments
Botox vs fillers for the lower face and neck is a frequent question. Fillers add structure and contour. Botox relaxes muscles. If a jawline lacks definition because the bone is retrusive or the chin is short, hyaluronic acid filler at the chin or angle can produce a dramatic change. If the contour is decent but masked by downward pull from the platysma or DAO, neuromodulators provide that elegant softening. Many patients benefit from a staged approach: first calm the muscles with botox, then assess where filler will be most efficient. For some, energy-based tightening like radiofrequency or ultrasound complements both.
What about botox vs Dysport, Xeomin, or Jeuveau? In capable hands, all are effective. Differences in diffusion and onset are minor in day-to-day practice. Some patients feel Dysport kicks in a day earlier; others prefer the precision they perceive with Botox or Xeomin. If you have allergies to certain proteins, Xeomin, which lacks complexing proteins, may be an option. Trust your injector’s comfort with a product rather than chasing brand hype.
Botox alternatives for the neck and jaw include thread lifts, which mechanically lift tissue but carry their own risks and require careful selection. For heavier laxity or pronounced jowls, surgical options still reign. If migraines, masseter hypertrophy, or TMJ issues coexist, botox for masseter or botox for TMJ can ease symptoms and harmonize the lower face, often paired thoughtfully with the Nefertiti pattern.
Aftercare That Actually Matters
Most aftercare advice can be boiled down to common sense. Keep the area clean the day of treatment, avoid heavy sweating or hot yoga for 24 hours, and resist the urge to rub or massage injection points. Sleep as usual. If you notice mild botox bruising, a cold compress in the first few hours helps, and arnica can be used if you prefer. Makeup may be applied later the same day, with gentle strokes and clean brushes.
If this is your first time botox experience, schedule the two-week check-in. The effect plateaus by then, and any tweaks are small and precise. If you have a special event, plan your appointment 2 to 3 weeks before, not after, so you are in the peak window. Do not chase touch-ups too early; let the full effect declare itself. If your provider recommends a botox touch up, ask them to explain the adjustment, whether it is symmetry, band persistence, or DAO rebalancing.
Natural Looking Results Without the “Frozen” Look
Patients worry that botox for face treatments will erase expression. Properly placed botox for jawline and botox for neck target muscles that pull down, not the ones that create your smile and laugh lines. You should still look like you, just less tense. The trick lies in dosing and landmarks. A skilled injector notes your baseline expressions and tailors units to maintain natural movement. Baby botox is a useful philosophy in the lower face; you can always add a bit more at two weeks if needed.
Botox myths persist. No, botox does not permanently “stretch” your skin. The long term effects of botox are generally favorable for etched-in lines because the skin creases less often, giving collagen a chance to reorganize. The risk of resistance is low with standard medical dosing, though spacing treatments reasonably and avoiding unnecessary top-ups is wise.
Planning a Smart Treatment Journey
If you are considering the Nefertiti lift, align timing, goals, and budget. Start with a clear botox consultation and photos. Ask your botox expert to show you where they plan to inject and what they expect to change. Discuss whether adjunctive treatments like light filler at the chin or energy-based tightening might enhance the result or if botox alone addresses your concerns. Clarify botox units, expected botox results, and the plan for maintenance.
Two notes from practice. First, if you are also doing botox for forehead or crow’s feet the same day, coordinate so your overall facial balance stays right. Relaxing the upper face can amplify the effect of a jawline lift because the entire face looks calmer. Second, men often need more units in the lower face and neck, especially if they lift heavy or clench. Dosing equality is not the goal; dosing accuracy is.
A Realistic Timeline for Results
Here is a simple expectation curve. Day 0: treated, slight pinpoints, maybe a faint bruise. Day 3 to 5: subtle softening, corners of mouth feel less pulled. Day 7 to 10: jawline looks cleaner in photos, vertical neck bands do not pop as easily. Day 14: peak effect. Week 6 to 8: still crisp, natural movement preserved. Weeks 10 to 14: gradual return of pre-treatment tension patterns, time to book the next session if you prefer continuity. Photos help you see changes you might miss in the mirror.
Choosing the Right Provider
Experience with lower face and neck anatomy matters more here than in many other botox services. Ask about training and complication management. A skilled botox nurse injector or physician will explain how they avoid the marginal mandibular nerve and how they assess platysma dominance. Look at their before-and-after examples of botox for chin dimpling, DAO relaxation, and platysma banding. Strong providers invite questions rather than rushing to inject.
If you are vetting clinics, do not rely only on botox deals or botox offers. Promotions are fine, but quality of assessment and follow-up should drive your choice. A clinic that pressures you into more units than you need or that glosses over botox risks is not doing you a favor.
A Simple Pre-Visit Checklist
- Bring reference photos that show your concerns from front and profile. List medications and supplements that could increase bruising, like fish oil or aspirin, and ask whether to pause them safely. Plan the appointment at least two weeks before events so you are at peak effect. Decide whether you prefer a conservative first pass or a bolder change, and share that clearly. Schedule the two-week review before you leave the clinic.
When to Consider Other Options First
Some situations call for different tools. If your main issue is a receding chin, filler in the chin and prejowl sulcus will do more than botox. If your neck skin is crepey with sun damage and little muscle banding, energy-based treatments combined with medical skincare pay better dividends. If you have substantial submental fat that blunts your jawline in every angle, fat reduction techniques, whether injectable or surgical, set a better foundation, after which a Nefertiti lift can fine-tune.
Patients with a history of neuromuscular disorders or difficulty swallowing need individualized plans and often a discussion with their primary physician. Pregnancy and breastfeeding are standard exclusions for elective botox treatment. If you have an important voice-heavy event or athletic competition, plan around it to avoid temporary sensation of neck fatigue.
Final Thoughts from the Treatment Room
A well-executed Nefertiti lift is subtle in the best way. Friends say you look rested. Photos from the side look cleaner. Your smile lifts rather than drags. The technique rewards precision, restraint, and anatomical understanding. It also rewards patients who embrace maintenance without overdoing it. If you are weighing botox for jawline and botox for neck, come in with a clear goal: a lighter lower face, fewer visible bands, a refined edge along the mandible. Paired with sensible skincare and sun protection, that investment tends to hold its value.
If you are new to neuromodulators, start with a detailed consultation and a measured plan. If you have used botox for forehead lines or crow’s feet and love the softening, the lower face is often the next logical step. Done thoughtfully, the Nefertiti lift delivers on its promise: elegant, quiet lift without announcing itself.