I read about a Botox neck lift. What is this and does it work? I thought Botox was for frown lines?

You are correct that Botox is typically used for the frown lines between the eyebrows.  Overuse of the muscles between the eyebrows causes deep vertical lines which we call frown lines.

If we look aging necks in the population, people with thinner necks with minimal fat tend to have "muscle bands" or platysmal muscle bands.  This is a thin sheet-like muscle under the neck skin.  The front edge of the muscle is what forms the edge of the muscle band.

If we lay a bed sheet on the ground with a clothes line under the bed sheet, then we pull on the clothes line, the clothesline will tent the bed sheet.  This is what happens with neck muscle bands.  As the platysmal muscle band contracts, it is very similar to the clothes line tenting the bed sheet.  

Botox is a neurotoxin, or a poison which selectively paralyzes or weakens the muscle that it is injected into.  The effects of Botox are temporary, and the strongest effect of paralysis last only about a month, but residual weakness of the muscle persists for up to 4-5 months.  The muscle strength gradually returns over the months after injection.

Even when the Botox completely paralyzes the platysmal muscle bands, sometimes the muscle already has skin wrapped around it, and the muscle bands look the same.  Maybe less "tense" but still there all the same.  The only way it really works is if the muscle bands protrude when the person "clenches" their jaw or flexes their neck muscles, but the neck profile is perfect when the person is relaxed. 

Only in these people does the botox on the muscle bands prevent the neck band from forming.

I hope this explanation makes some sense.

Best,

Dr. Yang

Thanks for your question. The so called Nefertiti Lift is when we place botox into the platysmal bands of the neck and along the jawline, to relax this muscle group which functions as a depressor- meaning it pulls downward on the tissues. If you grimace/sneer or bite down hard on something you may be able to feel this muscle kick into action. When it relaxes, the muscles which have the opposing action get the advantage and thus there is a subtle lift which occurs. The overall effect is usually that the jawline appears more defined. It does not have a significant effect on any skin that might be loose enough to be draping under the chin so to speak. I hope that helps.

"Injecting soft fillers like Belotero in this area can reduce lines, wrinkles and folds as well as improve skin texture with long-term collagen production. Fillers are being used more frequently to contour and lift rather than solely line fill. Of course, fillers are best used in combination with lasers and microneedling​ with PRP to get the optimal outcome.

I suggest getting a formal evaluation with a cosmetic dermatologist to create an individualized treatment plan that works for you. Best, Dr. Emer"