LAM FACIAL PLASTICS

Dr. Lam have you heard of the so called 'Nefertiti necklift'?

They inject botox along the jaw line to make it sharper. Here is the medline link:

[b]J Cosmet Laser Ther. 2007 Dec;9(4):249-52
The 'Nefertiti lift': a new technique for specific re-contouring of the jawline.
Levy PM.[/b]
\Botulinum toxin type A (BoNTA) is now used extensively for rejuvenation of the forehead, glabellar and periocular regions and there is increasing focus on treatment of the lower face. Although there is well-documented evidence for the efficacy of botulinum toxin in the correction of platysmal bands, little work has been done to explore its potential role in rejuvenation of the jawline. To date, effects in this area have been reported as a consequence of platysmal banding treatment and are inconsistent. Hesitancy to explore treatment may be due to evidence of a greater, more durable response to the toxin in the lower facial muscles as well as reports of increased potential migration and subsequent side effects. This paper describes a new technique using BoNTA (Vistabel); Allergan, Irvine, CA, USA) to drape the skin of the jawline contour and provide the visual effect of a 'mini lift'. Experience with 130 patients with doses of BoNTA up to 20 U is described. Patient satisfaction is extremely high and the specificity of dosing and technique has led to a low incidence of adverse effects. The 'Nefertiti lift' is a minimally invasive, effective and acceptable alternative for those patients seeking an effective way to push back surgery.

that sounds interesting. i asked my botox rep who also has never heard of it. she is doing some research for me. i will call her tonight after work to discuss.

however, my thoughts about botox are that botox should provide long term results in which the treated area starts to improve texture, tone, break bad habits, and soften wrinkles. the short term gains (which the nerfertiti necklift) are really in my opinion a waste of money if constantly done. however, i understand the desire to get some improvement. i am guessing that they hit the depressor anguli oris which may bring the corners of the mouth up and also relax the muscle pull on the jowl. however, i could be totally wrong. i do perform rare DAO injections but don't really pay attention to any jawline effects. it is easy to do. i just don't like doing things that are for just "window dressing" so to speak (i.e., again no long-term gains) and also that tend not to last that long.

perlane into the prejowl sulcus (in front of the jowl) can also provide a temporary jowl effacement until the person is ready to undergo a fat graft and or facelift as needed.
best,
sml

Unfortunately, I don't have access to the article - my university is subscribed to it online but the last 12 months are not accessible. I wonder if the 'satisfying results' were referring to lifting jowls only not making the whole jaw line more pronounced.

I spoke with my Botox rep, and she is trying to get a hold of the article for me.