Oh, how the humble botulinum toxin (aka Botox) continues to surprise us. These days, the versatility of the injectable extends far beyond the routine sprinkle to treat crow's feet or frown lines. Thanks to injector skill and product technology, we're seeing a plethora of innovative treatment areas (and sometimes trends) entering the chat, like lip flips and "trap tox." All it takes is one celebrity or influencer to divulge their skin secrets, and we're suddenly scouring the internet for more details. So, when Kim Kardashian casually dropped getting neck Botox in season three's trailer of Hulu's "The Kardashians," the location quickly became the new it-treatment in dermatologist offices and med spas everywhere.
But how exactly does neck Botox work? Why do people want this treatment? And how long does it last? We caught up with Los Angeles-based board-certified dermatologist Sonia Batra, MD, MSc, MPH, for answers on all things neck Botox. Keep scrolling for everything you'll need to know about this treatment.
What Is Neck Botox?
Simply put, neck Botox is the use of a neurotoxin (which isn't exclusive to the name brand Botox, but also other options like Xeomin, Dysport, and Daxxify) to relax the muscles and smooth the skin in the neck area. "It can be used both to soften vertical bands as well as tighten and lift sagging that occurs at the junction between the jawline and the upper neck," Dr. Batra says.
Injectors will target a thin, superficial sheet of muscles in the neck known as the platysma. This muscle's main function involves opening/closing the mouth and frowning, but it also happens to be the most susceptible to cosmetic change as we age (more on that below). "It can safely be targeted with neurotoxin without impacting function," Dr. Batra says. So don't worry, you'll still be able to slam a bag of chips and express disappointment.
What Does Neck Botox Treat?
Unlike neurotoxins in the trapezius muscles (known as trap tox), which creates the appearance of a more elongated neck by relaxing muscles at the tops of your shoulders, neck Botox injections are designed to treat the wrinkling and sagging of neck skin.
For a little anatomy lesson: The platysma muscle sheet rests on top of the harder, more functional neck muscles, and as we age, these muscles can begin to separate and cause vertical banding. "As the skin drapes on top of the separated muscle, you see rope-like projections that are especially prominent when you grit your teeth or tense the neck," Dr. Batra says.
On top of that, the platysma muscle is also prone to thinning, resulting in extra laxity or skin sagging along the jawline or the dreaded horizontal "tech neck" creases, caused by excessively looking down at phones. Now, raise your hand if you just lifted your chin up after reading that.
What to Expect in Neck Botox Treatments
Just like facial Botox, neck Botox treatments are quick, minimally invasive, and come with virtually no downtime. If you want a detailed play-by-play, one PS editor tried it for herself - you can see her neck Botox before and after shots. Numbing cream is applied to minimize discomfort and you may be left with a little residual redness at the injection site, which typically resolves by the next day.
The number of units used ultimately depends on the severity of banding or laxity. "On average, I start conservatively with the equivalent of 28 units of Botox and go up from there," Dr. Batra says.
Can You Combine Neck Botox With Other Treatments?
The short answer is yes, but timing will depend on what you're getting done. The neck area can easily be tacked onto appointments for facial Botox or volume-building fillers (like Juvederm or Restylane) and can be performed alongside platelet-rich plasma or microdroplet injections (like Skinvive) for tone and texture.
If you're considering lasers, you'll want to space out your appointments. "I frequently perform neurotoxin injections a couple of weeks before laser treatment so that the muscle is relaxed while the skin is healing. This often yields better results," Dr. Batra says.
How Long Does Neck Botox Last?
While there are averages, Dr. Batra notes that a multitude of factors can influence the appearance of results like your lifestyle, metabolism, and the type of neurotoxin used. Depending on your needs (like an event coming up), a provider may recommend trying a neuromodulator like Daxxify, which has a quicker onset. "The effects of Daxxify can often be seen more quickly than Botox, sometimes as soon as two days after injection," says Dr. Batra, in contrast to the four to seven days with Botox.
The longevity of results is determined by the product used and the number of units determined by your injector. "My target is around four months of results from Botox and around six months from Daxxify."
If you're interested in exploring neck Botox as a treatment option, talk with your doctor.