Quick Answer

Neck Botox (platysma Botox) is a botulinum toxin injection used to treat the prominent vertical bands (platysmal bands) and horizontal neck lines that develop in the anterior neck due to the platysma muscle. The procedure uses a total of 25–60 units of Botox, the effect lasts 3–5 months, and the treatment is completed within 15–20 minutes. When the neck and jawline are treated together using the Nefertiti lift technique, a striking rejuvenating effect is achieved. At Virtuana Clinic, neck rejuvenation is performed either as platysma Botox alone or as a Nefertiti lift combined with microbotox. Please contact us for current pricing.

Anatomy of the Platysma Muscle: Why Does the Neck Age?

The platysma is a broad, thin muscle situated just beneath the superficial cervical fascia, covering the anterior neck. Extending from the clavicle to the mandible (lower jaw), the platysma is the only superficial neck muscle and acts as a depressor (downward puller).

Two key age-related changes affect the platysma:

Platysmal Bands (Vertical Cords)

Over the years the medial borders of the platysma muscle separate from each other, forming vertical cord-like bands on the anterior neck surface. These bands become particularly prominent during speech, swallowing or head movements. Present in over 60% of individuals over the age of 40, this is the most significant component of the classic "ageing neck" appearance.

The Effect of the Platysma on the Face and Jawline

The platysma affects not only the neck but also the face. By pulling the lower face downward over time, the platysma contributes to loss of definition of the jawline, jowl formation (the part of the cheeks that falls below the mandibular border) and drooping of the corners of the mouth. For this reason, platysma Botox is an important component of lower face rejuvenation protocols, in addition to neck aesthetics.

Nefertiti Lift Technique: Injection Points and Dosing

The Nefertiti lift is a combined Botox application named after the sharp and defined jawline of Egyptian Queen Nefertiti, targeting both the neck and the jawline. The technique consists of two main components:

Platysmal Band Injections

Mandibular Border (Jawline) Injections

Total Nefertiti lift dose: 30–50 units (average 38 units)

Results become visible 5–7 days after the procedure and last 3–5 months. Typical outcomes include a more defined jawline, softened neck bands and an overall firmer neck appearance.

Microbotox vs. Classic Neck Botox: Which, for Whom?

Two different Botox injection techniques are used in the neck region. Each has different indications and mechanisms:

Feature Classic Botox (Deep Muscle) Microbotox (Superficial Intradermal)
Injection depth Intramuscular Superficial dermis (intradermal)
Mechanism of action Muscle paralysis / movement reduction Targets sweat glands and miniature muscle fibres
Number of injections 8–20 points 50–100 small micro-points
Dose 25–50 units 20–40 units (more diluted)
Primary indication Platysmal bands, Nefertiti lift Pore refinement, oily skin, fine lines, sweating
Effect on neck movement Slight movement restriction possible Does not affect expression
Duration of effect 3–5 months 2–4 months
Suitable patient profile Pronounced platysmal bands, jawline definition loss Open pores, oily skin, mild tightening desired

In the microbotox technique, Botox is diluted with saline in a 1:4 ratio and injected superficially to create numerous small depots. This method reduces sweating and smooths the skin surface by regulating superficial muscle activity, but does not target deep muscle issues such as platysmal bands.

MOAS Assessment: Patient Selection in Neck Botox

The MOAS (Minimal Optimal Aesthetic Score) is an assessment scale used in neck rejuvenation treatments. The following parameters are evaluated when planning treatment at Virtuana Clinic:

  1. Platysmal band prominence: Mild (grade 1) / Moderate (grade 2) / Pronounced (grade 3) / Very pronounced (grade 4)
  2. Depth of horizontal neck lines
  3. Mandibular contour definition: Is the jawline clear? Is there jowling?
  4. Degree of skin laxity: Botox is effective for minimal-to-moderate laxity; advanced laxity may require thread lifting or surgery
  5. Skin thickness and elasticity

For grade 1–2 platysmal bands, Botox alone produces excellent results. For grade 3–4, a Botox plus thread lifting combination yields more effective outcomes.

Effect of Platysma Botox on the Jawline

The most unexpected but most appreciated side-effect of platysma Botox is its lower face rejuvenation effect. By reducing the downward pulling force of the platysma, Botox:

Clinical data: In a 2022 study published in the Aesthetic Surgery Journal, 87% of 94 patients who underwent a Nefertiti lift reported a noticeable improvement in lower face contour, and 91% expressed overall satisfaction with the results.

Aftercare and Precautions

The neck region has some differences compared to the face; the post-procedure care protocol is therefore tailored accordingly:

After the procedure, mild redness at the injection points is normal for 1–3 days, and occasional minor bruising may occur. These are temporary and can be covered with make-up.

How Many Sessions Are Needed?

Neck Botox usually produces visible results in a single session. The full effect appears 5–10 days after the procedure and lasts 3–5 months. For some patients:

Neck Rejuvenation Protocol at Virtuana Clinic

Virtuana Clinic applies personalised combined protocols for neck rejuvenation:

Concern Recommended Treatment Sessions Duration of Effect
Mild platysmal bands Classic platysma Botox 1 3–5 months
Moderate-to-advanced bands + jawline Nefertiti lift (Botox) 1 3–5 months
Horizontal neck lines + sweating Microbotox 1–2 2–4 months
Skin quality + bands Nefertiti lift + Profhilo 2–3 6–9 months
Advanced laxity + bands Botox + PDO thread lifting 1–2 12–18 months

This article is for informational purposes only. Please consult a qualified physician for treatment decisions.