Indications

Queen Nefertiti of Ancient Egypt is referred to as one of the most beautiful women to have ever lived. Images of Nefertiti generally bring to mind a very graceful neck and a sculpted jawline, based on the famed 3,300-year-old bust found in Egypt in 1912 and now displayed in Berlin. In selected patients, the “Nefertiti neck lift” procedure uses BoNTA to increase the definition of the mandible.

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

Patient selection is extremely important when performing this procedure. Patients who desire a more defined mandibular contour should be assessed for the extent of platysmal pull on their lower face. It is suggested that the patient be asked to contract the platysma muscles; if the mandibular border becomes less visible, then this patient is a good candidate for the procedure.

Injections of BoNTA are placed along the inferior aspect of the mandible and in the upper aspect of the strongest lateral platysmal band. Injections are deep into the muscle; approximately 14 to 20 BU (or 42 to 60 DU) is used per side in equal injections.