The shape, position, and size of the mouth are important elements for the beauty and harmony of the face. The appearance, orientation, and position of the lip corners, as well as its relation to the rest of the facial structures may denote youth, aging, or sadness. Similar to the mouth, the neck region also plays an important role in facial harmony and youth. Laxity of the skin and deep structures, jowls or neck, vascular alterations, skin aging, and marked bands of the platysma muscle, when associated with lower face aging and jowling at the corner of the mouth, may all lead to a further aged face and neck.

At Castleknock Cosmetic Clinic Dublin there are various way, surgical and nonsurgical, which aim at improving this region, and each technique has its own indication criteria and varied outcomes. The main techniques used in this region of the face are the Minilift, Softlift, Skin Tightening or Multipolar Radiofrequency and Ultrasound Cavitation and last but not least botox injections to the region in the form of the Nefertiti Lift.
The application of botulinum toxin A (Botox, Dysport and Xeomin) in the jowl or oral region has been described by several skilled innovators before. The Nefertiti lift technique is suitable for patients with horizontal and vertical neck bands and with downturned oral commissures, without excessive skin laxity or fatty tissue. The Nefertiti lift with botox involves administering three or four injection sites with approximately Botox or Dysport or Xeomin mixed in a unique ratio of physiological sodium chloride solution.

The results obtained, weakening of the neck bands muscle and elevation and redefinition of the angle of the mouth become visible within 5 or 7 days following the injection and remain stable for a variable period of time. The effect is longer lasting in the neck region (4 months on average) than in the oral region (approximately 3 months).

Although the results can be better appreciated during movements of expression and facial animation, they can also be seen in the face and neck at rest. The best results are observed in younger patients who have greater muscular strength and no significant laxity or fatty jowls.