What muscles are involved in a Nefertiti lift and how do neuromodulators like Botox (Botulinum toxin) affect them cosmetically?

Muscles Involved in Nefertiti Lift and Botulinum Toxin Effects

The Nefertiti lift primarily targets the platysma muscle along the jawline and neck, where botulinum toxin injections cause temporary chemical denervation, resulting in reduced muscle pull and improved jawline definition by blocking acetylcholine release at neuromuscular junctions. 1, 2

Anatomy and Muscle Function

The key muscle involved in the Nefertiti lift procedure is:

• Platysma muscle:
  • A broad, sheet-like muscle extending from the chest and shoulder to the lower face
  • Acts as a major depressor of the lower face and jawline 3
  • When contracted, it creates visible bands in the neck and pulls down on facial tissues
  • Contributes to the appearance of jowls and loss of jawline definition

Mechanism of Action of Botulinum Toxin

Botulinum toxin works through a specific neurochemical process:

1. Chemical structure: A zinc-endopeptidase protein with heavy chain (100,000 daltons) and light chain (50,000 daltons) 4

2. Neuromuscular blockade:

   • Blocks acetylcholine release from presynaptic motor neuron terminals 4, 2
   • Prevents neurotransmitter from reaching the muscle fibers
   • Results in temporary chemical denervation and partial muscle paralysis 2

3. Duration of effect:

   • Effects are temporary (typically 3-4 months)
   • Recovery occurs through sprouting of new nerve terminals 4, 2

The Nefertiti Lift Technique

The procedure involves:

• Strategic injections along the inferior border of the mandible and into the platysmal bands 1, 5
• Typical dosing ranges up to 20 units of botulinum toxin type A (BoNTA) 1
• May use EMG guidance for precise targeting in complex facial musculature 4

Cosmetic Effects

The Nefertiti lift produces several aesthetic improvements:

• Jawline recontouring: Creates a sharper, more defined jawline 3
• Reduced platysmal banding: Softens visible neck bands both at rest and during muscle contraction 5
• "Mini-lift" effect: Drapes the skin along the jawline contour, creating a subtle lifting effect 1
• Jowl reduction: May provide modest improvement in jowl appearance 5

Patient Selection

The procedure is most effective for:

• Younger patients with platysma muscle hyperactivity
• Patients with retained skin elasticity
• Those seeking a minimally invasive alternative to surgery 1, 5

Clinical Considerations

• Precision is critical: Careful injection technique is essential to avoid complications 4
• Potential for migration: The lower facial muscles may show greater and more durable response to botulinum toxin, with increased potential for migration 1
• Combination approach: Can be used alone or with other rejuvenating procedures 5

The Nefertiti lift represents a targeted application of botulinum toxin's muscle-relaxing properties to achieve facial rejuvenation through addressing the specific muscular dynamics that contribute to lower face and neck aging.