When it comes to self-image, everyone has their thing. For some people, it’s their eyes, nose, or lips. My thing’s my neck. My childhood stuffed animal was a giraffe because I could always relate. Necklace-wielding jewelry store staff always race toward me with their eyes on an obvious sale. The rule about no-face nudes doesn’t exactly apply to me; my neck is the tell. If past lives exist, I was huge in ancient Egypt. My home vanity is like the work of a miniature beaver: products everywhere that are obscure but clearly not random. My evening neck routine varies on a theme: cleansing milk, manual exfoliation, a chemical exfoliating toner, active serum, some form of tretinoin or retinol, and a heavy cream or oil. All of that isn’t enough to combat the dreaded tech-neck our generation has been plagued with. After all, I got my first Blackberry in the sixth grade (RIP BBM). Too small for dermal fillers and impervious to lasers or surgical lifts, these neck lines can be seriously evil. Lo and behold, I found their napalm.
Whenever needles, cannulas, or emotional support are involved, Babak Azizzadeh, MD, FACS, in Beverly Hills is my go-to. He’s famous for his work on Mary Jo Buttafuoco’s life-altering facial paralysis corrective surgery (remember the Long Island Lolita?) as well as his aesthetic work on a long list of Hollywood’s most recognizable starlets. When I asked him what I should do about my neck lines, he had the solution: neck Botox. Apparently, a little-known off-label technique for ol’ faithful (i.e. Botox) is using it to paralyze neck muscles and smooth out fine lines. And after trying other options (more on that below) only to have yet another failure under my belt, I was all in.
For more about neck Botox and the results I saw, keep reading.
What Is Neck Botox?
Neck Botox is, simply put, an injection of Botox into the neck for the purposes of paralyzing the neck muscles, thereby reducing wrinkles and fine lines. Ever notice those horizontal wrinkles that line your neck? Those are the targets of neck Botox. "Botox in the neck is more useful for improving the jawline than the neck itself in most cases," says dermatologist Julia Carroll, MD, of Toronto's Compass Dermatology.
Benefits of Neck Botox
• Reduces wrinkles
• Improves fine lines
• Targets sagging jowls
Botox is the gold standard for wrinkle reduction but, since it targets the muscles, it actually does much more. "It relaxes the muscles of the neck that pull down the jawline, thereby improving the jawline," says Carroll. That means that neck Botox can effectively tighten the skin, adding subtle changes to the shape of the jaw and neck, slimming it down and reducing sagging skin.
Neck Botox vs. Ultherapy and Resurfacing Lasers
There are, of course, other options for neck wrinkles, though, in my experience, they haven't been as effective. Ultherapy, or high-intensity focused ultrasound, is a treatment that targets deep levels of the dermis by heating up and traumatizing cells using an ultrasound machine in order to generate new collagen. I chose this to tighten my skin, thus hopefully making lines go away. It was incredibly painful, and three unbearable sessions yielded no result or reward. For me, there’s nothing worse than pain without gain. Reference point: I get dental fillings with no Novocaine or analgesic, and I highly recommend taking the prescription painkillers they give you before Ultherapy.
Alma’s Pixel RF resurfacing laser uses radiofrequency to target problem areas. It left me with scabby track marks that made my neck look like a crop field. This was also very painful, or “spicy” as the tech called it. After seeing this laser work wonders on making stretch marks disappear after only one treatment, I was very hopeful. My neck’s texture and tone looked great once the little scabs came off, but my lines remained the same. Ayurvedic skin-tightening treatments like Kaya Lepam (an exotic wrap treatment with milks and herbs) felt great for my soul but did nothing for my neck. I refused to give up, though, so I booked my appointment for neck Botox and crossed my fingers that it was the long-awaited solution for my pesky little neck lines.
How to Prepare for a Neck Botox Treatment
Botox is a fairly easy lunchtime procedure, meaning it requires little time and not much in terms of preparation. The main thing to do is to try to make it as easy as possible for the physician to get to the problem area. "The best way to prepare for treatment is to arrive with a clean, product-free neck and ideally wear a V-neck or loose-collared shirt," says Carroll.
What to Expect When Getting Neck Botox
When you arrive at the office, the physician will ensure the area is clean (and possibly provide you with a stress ball, if you're worried about pain) and get to work injecting. The entire process won't last longer than a few minutes.
To my surprise, I felt my neck tightening up after a mere 48 hours (usually Botox treatments set in after three to five days for me.) I love how smooth and tight my skin is, and my jawline has the added benefit of a slight lift and tightening. When I look at my phone in bed before I go to sleep, I don’t feel the usual eye-strain and pressure in my temples I used to from curling my head downward. When I make the Animal Muppet face, my neck doesn’t move.
Whenever receiving a Botox treatment, there are a few aftercare instructions to keep in mind. One is not to do any strenuous activities for the next 24 hours, so that the Botox won't migrate elsewhere in the body. Another is to stay upright for four hours after your treatment (again, to avoid the Botox migrating) and try not to massage the area for a while. The area might feel tight for a bit after (see above), but any minor pain can be remedied with over-the-counter painkillers.
As with all Botox treatments, the results won't last forever, and every four months or so appointments will be needed to ensure your wrinkles stay away.
Overall, neck Botox has got me in my best feelings. I’ve always been good at the French exit (leaving a party without saying goodbye.) I didn’t have a chance to formally bid my neck lines adieu, but now, I’ve definitely said farewell—at least for the next four to six months.
Lee JH, Park YG, Park ES. A prospective observational study of the effectiveness and safety of botulinum toxin in the horizontal neck lines. Aesthetic Plast Surg. 2018;42(5):1370-1378. doi:10.1007/s00266-018-1160-8
American Society for Dermatologic Surgery. Neuromodulators.
American Society for Dermatologic Surgery. Ultrasound therapy for sagging skin.
Gentile RD, Kinney BM, Sadick NS. Radiofrequency technology in face and neck rejuvenation. Facial Plast Surg Clin North Am. 2018;26(2):123-134. doi:10.1016/j.fsc.2017.12.003