Nefertiti Neck Lift
The Ancient Egyptian Queen Nefertiti has been referred to as one of the most beautiful women to have ever lived. Images of Nefertiti bring to mind a long graceful neck and a sculpted jawline, based on the famed 3,300-year-old bust that was discovered in Egypt in 1912 and now displayed in Berlin. The “Nefertiti neck lift” procedure uses botulinum toxin to increase the definition of the mandible, in selected clients.
Anatomic Considerations
The platysma muscle is a neck depressor. It originates at the clavicle and fascia of the upper chest and inserts onto the mandible and skin of the chin and cheek. Release of the downward pull of the platysma will allow the facial elevators to elevate the sagging skin over the lower face and more clearly define the mandibular border.
Injection Technique
Client selection is important when performing this treatment. Clients who desire a more defined mandibular contour should be assessed for the extent of a platysmal pull on their lower face. It is suggested that the client be asked to contract the platysma muscles; if the mandibular border becomes less visible, the client is a good candidate for this procedure. Injections of botulinum toxin are placed along the inferior aspect of the mandible and in the upper aspect of the strongest lateral platysma band. Injections are deep into the muscle; approximately 14 to 20 units of botulinum toxin is used per side in equal injections.
Precautions
Extending these injections too far medially can affect the depressor labii inferioris and cause a lip droop or asymmetric smile. Do not inject medial to a line drawn down from the nasolabial fold to the mandible.
Risks
Over-injection of this area can result in dysphagia, or an irregular smile. Excessive pull upward on the lower face can result in an irregular bunching of the tissue over the mandible.