Botox for the Neck and Jawline

This is a family of related neuromodulator techniques that address the muscles pulling the lower face downward. Small doses of botulinum toxin (Botox, Dysport, Jeuveau, Xeomin, or Daxxify) are placed along the platysma bands of the neck, along the inferior border of the jawline, and, when appropriate, into the depressor anguli oris at the corners of the mouth. Relaxing the downward-pulling muscles lets the elevator muscles of the face work with less opposition, which softens vertical neck bands, lifts and defines the jawline, and improves the resting position of the mouth.

In October 2024, the FDA approved Botox Cosmetic for moderate-to-severe platysma bands in adults – the first neurotoxin with an on-label indication in the neck. Treatment of the depressor anguli oris remains off-label, though is well established in the aesthetic literature.

The Nefertiti lift – named for the defined jawline seen in ancient sculptures of Queen Nefertiti – is a specific injection pattern along the platysma at the inferior aspect of the jawline. It remains a foundational technique for restoring jawline definition, and the injection points mimic those used in treatment of the platysma. Dr. Hibler often incorporates it alongside treatment of the platysma bands and DAOs when anatomy suggests it will improve the result.

This approach is most effective for patients with early to moderate loss of jawline definition, visible platysma bands with animation or at rest, and reasonably good skin quality of the lower face and neck. Candidacy depends on the strength of the underlying muscles rather than age alone. Patients with significant skin laxity, heavy jowling from volume loss, or prominent submental fat often benefit more from a combination approach that pairs neuromodulator treatment with tissue tightening, filler, or fat reduction. Dr. Hibler will offer an honest assessment during the consultation.

The technique addresses several related concerns at once:

• Vertical platysma bands
• Softening of the jawline caused by chronic downward pull of the platysma
• Downturned corners of the mouth from an overactive depressor anguli oris
• Marionette lines, where softening the DAO reduces the underlying muscular pull
• Chin dimpling, when the mentalis is treated as part of a broader plan

It does not address significant skin laxity or fat deposits. When these are present, Dr. Hibler will discuss combining neuromodulator treatment with tissue tightening, filler, or non-invasive fat reduction of the submental area.

A session typically takes fifteen minutes. Dr. Hibler examines the muscles of the jawline and neck at rest and in animation, then identifies injection points along the platysma bands, along the posterior edge of the platysma at the jawline, and at the DAO when indicated. Very fine needles are used, and most patients tolerate the procedure comfortably without topical anesthetic. There is no downtime. Mild redness, tenderness, or a small amount of bruising may occur and typically resolves within a few days.