The Nefertiti Lift: Can Botox Tighten an Aging Jaw Line?

Many of my middle-aged patients complain that their jaw lines are loose and poorly defined….

    

• With aging, the skin sags, and the cheeks tend "to fall" towards the neck.
• The excess skin obscures the jaw line and effaces the distinction between the face and the neck.
• The lack of well-defined jaw line is a sign of aging and is a cause of reasonable concern.     

Can Botox be a solution?!  Can a “Nefertiti Lift” with Botox restore a youthful lower-face contour?

    

Probably not.

    

In the Journal of Cosmetic and Laser Therapy, Dr. Philip Levy (a dermatologist who practices in both Switzerland and France) describes a new technique for re-contouring the jaw line using Botox.  Proclaimed the “Nefertiti Lift,” 30-40 units of Botox are injected along the lower jaw line and the sides of the neck.  Among Dr. Levy’s 130 Nefertiti-Lift patients, he claims “success” in 126.

    

While the idea is intriguing, Dr. Levy’s experience cannot be interpreted as a breakthrough.  There are methodological problems with his study.

• Dr. Levy did not randomize his patients.  To do a good research study, he should have used Botox on one patient but just plain saline (injectable salt water) on another patient.  Or, he could have injected Botox on one side of an individual patient and the saline placebo on the other.  Good studies require a control.
• Dr. Levy evaluated his own results.  He may have been biased.  Of course, we all hope that our own techniques are effective!  An independent colleague (or a group of colleagues) should have evaluated the treatment.  (And those colleagues should have had no prior knowledge as to which patient--or which side of a patient--received treatment.)
• Dr. Levy did not define "success."  He assumes that his assessment of what is good and bad is adequate.  In fact, there are accepted protocols for measuring aesthetic improvements.  Why not use them?
• Dr. Levy's photographs are not standardized.  Differences in lighting and head positioning can account for what he considers to be improvements from the Botox.
• Many of Dr. Levy's patients, who had "successful" results, also complained of asymmetrical smiles and temporary difficulties in swallowing.  Since one of Botox's main attractions is its safety and the rarity of side effects, one wonders why a patient would risk significant complications with her smile or her swallowing for (only possible) improvements in her jaw line.

 

I apologize for being a Doubting Thomas.  And I certainly don’t mean to pick on Dr. Levy.  I do appreciate his attempts at innovation!  I, too, am hopeful that non-surgical techniques for jaw line restoration are on the horizon.  Perhaps, the Nefertiti Lift will be a solution, but I suspect that Dr. Levy’s results will not be reproducible.

Comments

[BERNADETTE]

I watched over the weekend a documentary on the BBC, a woman went to Dr. Brandt who also did this type of jaw, jowl lift with Botox. It looked to do a great job!
This is what I am researching online for today and came across your thoughts. Maybe you could check this out.

[dermatology upland]

That's the reason why i need to undergo a botox treatment,all i wanna if it's so painful?

by: sphin