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Chapter 1111 min read

Platysma and Nefertiti Lifting: The Youth of the Neckline

Neck lines and sagging jowls make the face look older than it is. Platysma botox (Nefertiti lifting) silences the downward pulling effect of the neck muscle and lifts the jawline upwards.

Main ideas in this chapter

  • The platysma is a broad neck muscle; when contracted, it pulls the jawline downwards.
  • The Nefertiti technique takes its name from the long, defined jawline of the ancient Egyptian queen.
  • It is not an alternative to surgical facelift, but an early intervention option.
Profilden boyun ve çene hattı — platysma anatomisi
Image:The neckline is the quietest indicator of the face's age.· Unsplash (royalty-free)

What is the platysma?

The platysma is a thin but broad neck muscle that extends from the upper chest to the jawline. It exerts a downward pulling force — when contracted, the lower face and neck move forward/downward. With tense speech, stress, and aging, platysma activity increases, and the jawline succumbs to this downward force.

At the same time, the two anterior strips of the platysma (medial bands) become prominent "two cords" with age. These cords become visible in the midline of the neck and are one of the most common complaints of patients.

Nefertiti lifting technique

Nefertiti lifting was described in the 2010s by dermatologist Anthony Benedetto. It involves injecting small doses of botox along the upper edge of the platysma and the jawline. When the muscle loses its downward pulling effect, the jawline lifts itself upward with its own elevator forces. Result: the jawline becomes more defined, and the lower face is lifted upward.

The technique is named in reference to the long, defined, elegant jawline in the sculptures of the ancient Egyptian queen Nefertiti. In the right patient, the result gives the impression of a non-surgical "mini facelift."

Who is it suitable for, and who is it not suitable for?

Suitable candidates: patients aged 35-55, whose skin has not significantly lost its elasticity, who have prominent platysma bands, and who experience mild jawline loss. In these patients, botox alone can yield dramatic results. Unsuitable candidates: advanced age, excessive skin sagging, laxity after significant weight loss. In these patients, botox is insufficient; surgical facelift or thread lift is required.

For realistic expectation management, I perform a "finger lift test" during the examination: I gently lift the skin under the jaw upward with my finger and show the patient a mirror. This test shows approximately 60-70% of the effect that can be achieved with botox. If the patient is satisfied with this effect, the procedure is planned; if not, other options are discussed.

Dose and injection map

The total dose is between 20-40 units. 2-3 units at 4-6 points on each side along the jawline, and 2 units at 3-4 points starting from the upper end of the platysma bands (anterior cords). The injection is superficial; a deep needle can affect muscles involved in swallowing (digastric, geniohyoid).

The effect becomes visible in 2 weeks and settles after 3-4 weeks. The result lasts for 3-5 months — slightly shorter than facial botox because the platysma is an actively used muscle. The re-treatment interval is usually 4 months.

Attention:Incorrect injection in inexperienced hands can cause side effects such as difficulty swallowing, voice changes, and submandibular asymmetry. Platysma botox is not an "entry-level" procedure; the physician's anatomical experience directly determines safety.

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