What are the considerations and guidelines for a Dysport (botulinum toxin) Nefertiti neck lift procedure?

Dysport Nefertiti Neck Lift: Considerations and Guidelines

The Dysport Nefertiti neck lift should be performed only by experienced clinicians with excellent knowledge of neck and facial musculature, as improper technique can lead to serious adverse effects including dysphagia and respiratory compromise. 1, 2

Procedure Overview

The Nefertiti lift is a specialized botulinum toxin injection technique that:

• Targets the platysmal bands and the inferior border of the mandible
• Aims to recontour the jawline and improve neck appearance
• Creates a "mini-lift" effect without surgery
• Is named after the Egyptian queen known for her elegant neck and jawline 3

Patient Selection Criteria

Ideal Candidates

• Younger patients with platysmal muscle hyperactivity
• Patients with retained skin elasticity
• Those with visible platysmal bands
• Patients seeking jawline definition 4

Contraindications

• Hypersensitivity to botulinum toxin or any components in the formulation
• Active infection at the injection site
• Pre-existing neuromuscular disorders (e.g., myasthenia gravis, Lambert-Eaton syndrome)
• Marked facial asymmetry requiring correction
• Excessive weakness or atrophy in target muscles 5

Technical Considerations

Dosing

• Standard dosing for Dysport in the neck region should be carefully calculated
• Typical doses range from 15-20 units per injection point
• Total dose should not exceed recommended guidelines for cervical region
• Lower doses than those used in upper face are often sufficient 3, 4

Injection Technique

1. Identify key anatomical landmarks:

   • Platysmal bands
   • Inferior border of mandible
   • Sternocleidomastoid muscle

2. Proper injection points:

   • Along the inferior border of the mandible
   • Into the platysmal bands
   • Avoid injection into the sternocleidomastoid muscle to reduce risk of dysphagia 2, 3

3. Injection depth:

   • Superficial to mid-depth injections for platysmal bands
   • Careful depth control to avoid deep neck structures

Safety Considerations

Potential Adverse Effects

• Dysphagia (difficulty swallowing)
• Dysphonia (voice changes)
• Neck muscle weakness
• Respiratory compromise in severe cases
• Asymmetry of results
• Pain at injection sites 5

Risk Minimization

• Use appropriate doses (lower than facial applications)
• Precise injection technique
• Avoid injection into sternocleidomastoid muscle
• Ensure proper anatomical knowledge
• Avoid bilateral injections into sternocleidomastoid muscles, as patients with smaller neck muscle mass are at greater risk for dysphagia 5

Expected Outcomes and Follow-up

Results

• Improvement in platysmal bands (both at rest and with maximal tension)
• Enhanced jawline definition
• Potential improvement in jowls and marionette lines
• Effect duration typically 3-4 months 4, 6

Follow-up Care

• Assessment at 2 weeks post-procedure
• Monitor for any adverse effects
• Consider touch-up injections if needed
• Schedule maintenance treatments every 3-4 months 6

Special Considerations

Combination Approaches

• The Nefertiti lift is often complementary to other aesthetic procedures
• Can be combined with dermal fillers for enhanced results
• May be part of a comprehensive facial rejuvenation plan 2

Limitations

• Less effective for patients with significant skin laxity
• Not a replacement for surgical neck lift in advanced aging
• Results are temporary and require maintenance 4

Conclusion

The Dysport Nefertiti neck lift can provide effective jawline recontouring and platysmal band improvement when performed correctly. Patient selection, precise technique, and appropriate dosing are critical for optimal outcomes and safety. This procedure should only be performed by clinicians with thorough understanding of neck anatomy and experience with botulinum toxin injections.