The Nefertiti Lift and Neck Botox: What Each One Actually Treats

By Lucas, Founder & Lead Researcher

Reviewed for medical accuracy against our Medical Review Board  ·  Last updated 19 August 2026

Part of Botox by Facial Area

Neck Botox treats the vertical cords that stand out when you tense your neck, and it takes roughly 25 to 50 units. It does very little for the horizontal creases people photograph and call tech neck, because those are skin rather than muscle. This is also the area where getting it wrong carries the most serious consequences.

Two completely different complaints arrive under the same heading. One responds well to a neurotoxin. The other does not respond at all, and being sold the treatment anyway is the most common disappointment in this area.

1. Two different necks, one treatment

When people say they want something done about their neck, they almost always mean one of these, and the two have nothing in common except location:

The second one is what most people mean by tech neck, and it is the one clinics are most often asked about. It is worth being clear before you spend anything: relaxing a muscle does not remove a crease that is set into the skin. Section 7 covers what does.

2. The mirror test that tells you which you have

Most people over forty have some of both, in which case the honest answer is that Botox handles part of the problem and something else handles the rest. An injector who tells you a single treatment fixes both is either not looking or not telling you.

3. The platysma, and why it pulls down

The platysma is a broad, thin sheet of muscle running from the collarbone up over the front of the neck and into the lower face. It is unusual: most facial muscles are compact, and this one is a wide sheet just under the skin.

Its action is to pull down. It depresses the corner of the mouth and drags on the jawline. As it thickens and tightens with age, two things happen. The free edges of the sheet start to stand out as visible vertical cords, and the constant downward pull works against the muscles that hold the lower face up.

That second point is the interesting one, and it is what section 4 is about. Relaxing a muscle whose job is to pull down does more than just soften the cords.

4. The Nefertiti lift, and what it can honestly do

The Nefertiti lift is the name given to treating the platysma along the underside of the jawline as well as in the neck, so the downward pull is released along the mandibular border. The name refers to the jawline on the famous bust.

Here is the part that has quietly stopped being true, and almost nothing written about this technique has caught up. The Nefertiti lift is routinely described as an off-label use of Botox. Its jawline component is not. When the platysma indication was added to the BOTOX Cosmetic label in October 2024, the labelled injection pattern included the jawline:

0.05 mL (2 Units) into each of 4 sites in the upper segment of the platysma muscles, below the jawline on each side and 0.025 mL (1 Unit) into 5 sites on each vertical neck band per side (1 to 2 bands per side) for a total of 26 Units, 31 Units, or 36 Units (18, 23, or 28 injection sites, respectively).

Read the first clause. Four sites per side, below the jawline, at 2 units each. That is eight sites and sixteen units of labelled jawline treatment, and it is the thing the Nefertiti lift is named for. The three published totals decompose cleanly once you see it:

What it can genuinely do: soften the cords, reduce the downward drag, and give a slightly crisper jawline in someone whose jawline is being pulled on rather than buried.

What it cannot do, and this needs saying because it is marketed hard:

• It is not a substitute for a neck lift. If there is loose skin, it will still be loose. Releasing a muscle does not remove tissue.
• It does not treat submental fat. A full under-chin area is a volume problem, and relaxing the platysma does nothing to it. That is a different treatment entirely, which our Botox versus Kybella comparison covers.
• The effect is subtle. Expect a softening, not a transformation. Before-and-after photographs of this treatment are frequently taken at different head angles, which does more work than the injection did.

It is a good treatment for the right neck. It is oversold for every other neck.

5. How many units, and why the range is wide

The usual working range is 25 to 50 units across the neck and jawline, and the range is wider here than anywhere else on the face for a simple reason: it depends entirely on how many bands you have and how long they are.

• Two prominent bands might take 20 to 30 units in total, placed along the length of each cord rather than in one spot.
• A Nefertiti approach adds a line of small doses along the underside of the jaw, pushing the total higher.
• Injections are placed along the band, not clustered, because the target is a long thin edge of muscle rather than a compact bundle.
• Superficial is the point. The platysma sits directly under the skin. Depth is covered in the next section and it is the thing that matters most here.

Treating the platysma is now on-label in the United States: moderate to severe platysma bands were added to the Botox Cosmetic label revised October 2024, as a fourth cosmetic indication alongside frown lines, crow's feet and forehead lines. Full dosing for every area is in our units guide and calculator.

6. The one area where the risk is genuinely serious

Everywhere else on this site, the honest summary of risk is that mistakes are temporary and cosmetic. The neck is different, and it deserves a plain warning rather than a reassuring one.

Directly beneath and around the platysma are the muscles you use to swallow and to hold your head up. Botox injected too deeply, or in too large a dose, can affect them. The recognised risks are:

• Difficulty swallowing. This is the one that matters. It is uncommon with correct technique, and it is the reason the injection has to stay superficial in a sheet of muscle that sits just under the skin.
• Neck weakness. A heavy-headed feeling, most noticeable lifting your head from a pillow or holding it forward.
• Voice changes or hoarseness, from spread towards the structures of the larynx.
• An uneven smile, since the platysma connects into the lower face and the muscles that move the mouth are close by.

All of these resolve, because there is no reversal agent and everything wears off. But "it resolves in three months" is a far less comfortable sentence when the symptom is trouble swallowing than when it is a heavy brow.

7. What actually works for horizontal neck lines

If your mirror test showed lines at rest, here is the honest menu, and Botox is not on it:

• Skin boosters and hyaluronic acid, placed to hydrate and thicken thin neck skin. See Botox versus skin boosters.
• Microneedling and radiofrequency microneedling, which work on the collagen in the skin itself. See Botox versus microneedling.
• Energy-based tightening for laxity, covered in Botox versus radiofrequency tightening.
• Sun protection on your neck, which almost nobody does and which is the reason neck skin so often looks a decade older than the face above it.
• Surgery, if there is genuine skin excess. Nothing injectable substitutes for it.

A realistic plan for most people over forty is Botox for the bands plus a skin treatment for the creases, staged rather than combined.

8. What it costs at real published rates

Below is 25 to 50 units against the per-unit prices published by clinics in the cities we verify.

These are rates clinics actually publish, read off their own price pages rather than estimated: the floor is $9 a unit in Atlanta, GA and the ceiling $18 in Tampa, FL. Your own city may sit outside that range entirely. We check published pricing city by city, and the locations index lists every city covered so far, with the named clinics and their rates.

Several clinics price the neck as a package rather than per unit, sometimes described as starting from a figure. As with the masseter, ask how many units that covers and what happens if you need more. Our Botox price guide covers the per-unit versus per-area question.

9. How long it lasts

Roughly three to four months, similar to the upper face, with onset in a few days and full effect at about two weeks.

Some people find neck results fade a little sooner. The platysma is large, the dose is spread thin along the length of each band rather than concentrated, and the muscle is active whenever you talk or swallow. A thin dose in a busy sheet of muscle recovers faster than a concentrated dose in a compact one, which is the same reason described for the forehead.

It does not build the way masseter treatment does, because you are not waiting for the muscle to shrink. What you get at two weeks is what the treatment does.

10. What to ask before you agree

Every area Botox treats, and what each one takes

Frequently asked questions

Written by

Lucas Pradella

Founder & Lead Researcher, BestBotoxClinics.com

Lucas founded BestBotoxClinics.com to bring clarity to the aesthetics industry, bringing 13+ years of experience in digital research and analysing online data for signals of quality and trust. He is not a physician, his work is research, data analysis and verifying provider credentials.

More about Lucas  ·  How we work

Medical accuracy: BestBotoxClinics.com maintains a Medical Review Board of licensed clinicians. This article is educational and is not medical advice.

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