You've probably seen them on your feed. Those side-by-side neck botox before and after pictures where a sagging jawline suddenly looks like it belongs to a Greek statue. It's tempting to think it's just a filter or some clever lighting. Honestly? Sometimes it is. But when you look at clinical results from actual dermatologists, the reality of "Nefertiti Lifts" and "Trap Tox" is a bit more nuanced than a thirty-second TikTok would have you believe.
Botox in the neck isn't a one-size-fits-all miracle.
It targets the platysma muscle. This is a thin, wide sheet of muscle that runs from your jawline down to your collarbone. As we age, or just because of genetics, this muscle can get hyperactive. It pulls down on the lower face. It creates those vertical "bands" that make you look like you’re straining even when you're just sitting there. When a provider injects neurotoxins like Botox, Dysport, or Daxxify into these bands, the muscle relaxes. The downward pull stops.
The result? A sharper jawline.
But don't expect a surgical neck lift. If you have significant skin laxity—what people call "turkey neck"—Botox won't fix that. It's for muscle tension, not for removing three inches of excess skin. That’s the first thing most people get wrong when they start scrolling through neck botox before and after pictures expecting a total transformation.
The Science Behind the "Nefertiti Lift"
The Nefertiti Lift is probably the most famous application of neck Botox. It’s named after the Egyptian Queen known for her long, elegant neck. Doctors use a series of injections along the lower jawline and down the platysmal bands. By relaxing the muscles that pull down, the muscles that pull up (the elevators in your cheeks) can do their job better.
It’s basically a tug-of-war.
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When the "downers" lose their strength, the "uppers" win. This creates a temporary lifting effect. Dr. Phillip Werschler, a clinical associate professor of medicine/dermatology at the University of Washington, has noted in various dermatological forums that the technique is highly effective for patients with early signs of jowling. However, he often emphasizes that patient selection is everything. If you have a lot of submental fat (a double chin), the Botox won't show through. You'd need something like Kybella or CoolSculpting first to see the muscle definition.
Most people need between 20 to 50 units. That's a lot. Compare that to the 10 or 12 units you might get for "crow's feet" around the eyes. Because the platysma is a large muscle, it drinks up the toxin. This makes it an expensive habit.
Why Some Before and After Photos Look Better Than Others
If you're looking at neck botox before and after pictures and wondering why some people look snatched while others look barely different, it usually comes down to three things: dosage, placement, and the "Tech Neck" factor.
We are all hunched over. Constantly.
Looking down at a phone for six hours a day forces the neck muscles to overwork. This causes horizontal lines (the "necklace lines") and worsens the vertical bands. When you look at a successful "after" photo, you’re seeing the result of those bands being softened. The skin looks smoother because the muscle underneath isn't constantly bunching it up.
Real Talk on Longevity
Botox in the neck tends to wear off faster than Botox in the forehead. Why? Movement. You move your neck constantly. You talk, you eat, you turn your head to check your blind spot while driving. Most clinical data suggests the effects last about 3 to 4 months. If you’re a heavy sweater or a marathon runner, you might find it vanishes even sooner.
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Some patients report that after several consecutive treatments, the muscle "learns" to stay relaxed. This is muscle atrophy. It sounds scary, but in the world of aesthetics, it's often the goal. A smaller, weaker platysma means a smoother neck.
The Rise of "Trap Tox" for the Slimmed Neck Look
Recently, the conversation around neck botox before and after pictures has shifted toward the Trapezius muscle. While not technically the front of the neck, injecting the traps (the muscles between your neck and shoulders) creates the illusion of a longer, slimmer neck.
It’s huge in Korea. Now it’s huge everywhere.
By relaxing the traps, the shoulders drop. This elongates the neck line. In "before" photos, patients often look hunched or "bulky" in the shoulder area. In "after" photos, the silhouette is much more feminine and slender. It also happens to help with tension headaches, which is a nice side effect. But again, you're looking at 40 to 100 units total. Your wallet will feel that.
Misconceptions That Could Ruin Your Results
There is a big myth that Botox "tightens" skin. It does not. It paralyzes (or softens) muscle. If your goal is to get rid of crepey skin texture, you’re looking at the wrong treatment. You’d be better off with a CO2 laser, Profhilo, or radiofrequency microneedling like Morpheus8.
Another thing? The "Botox Shelf."
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If a provider injects too much or in the wrong spot, it can occasionally affect your swallow or the way you smile. This is why you don't go to a "Botox party" in someone's basement for neck injections. The anatomy of the neck is a literal minefield of vital structures. You want someone who knows the difference between the superficial platysma and the deep muscles involved in laryngeal function.
What to Look for in Photos:
- Consistent Lighting: If the "before" is in a dark room and the "after" is in bright sunlight, ignore it.
- Posture: Make sure the patient isn't jutting their jaw out in the after photo to fake a result.
- The Angle: The camera should be at the same height in both shots.
The Timeline: When Do You See the Change?
Don't expect to walk out of the clinic looking like a supermodel. Botox takes time. Usually, you’ll start to feel a "tightness" or a slight difference in 3 to 5 days. The full "after" look—the one you see in those neck botox before and after pictures—takes a full 14 days to settle.
During that first week, you might even feel a little weird. Some people describe a sensation of their neck being "heavy" because the muscles they usually use to hold their head up are suddenly offline. It passes. But it's something nobody mentions on Instagram.
Cost vs. Value: Is it Worth It?
Let's do the math. If you're getting 40 units at $15 a unit, that’s $600 every four months. That is $1,800 a year just for your neck. For some, the boost in confidence and the sharpened jawline is worth every penny. For others, it's a lot of money for a subtle change.
If you’re seeing early jowling and you aren't ready for a surgical facelift (which can cost $15,000+), Botox is a great "bridge" treatment. It buys you time. It slows down the progression of those deep bands.
Practical Steps Before You Book
If you're serious about moving beyond just looking at neck botox before and after pictures and actually getting the procedure done, do your homework.
- Check the Injector's Portfolio: Don't just look at their forehead work. Ask specifically to see neck results. The neck is harder to get right than the "11 lines" between your eyes.
- Consultation is Key: A good doctor will tell you if you're a bad candidate. If they try to sell you Botox when you clearly have skin laxity that needs surgery, walk away.
- Preparation: Avoid alcohol and blood thinners like aspirin for 48 hours before. This minimizes bruising. The skin on the neck is thin; if you bruise, you'll look like you’ve been strangled for a week.
- Aftercare: Don't lie down for four hours after the injections. Don't go to the gym that night. Let the toxin settle where it was placed.
The reality of neck Botox is that it is a "tweakment." It's about refinement. When done correctly, the "after" isn't a different person; it's just a more rested, slightly more defined version of the "before." It won't give you a new face, but it might just make you stop hating your profile in Zoom meetings.
Focus on finding a provider who prioritizes natural movement. A frozen neck looks weird. A relaxed neck looks youthful. Choose the latter.