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What Is a Botox Lift (Sternocleidomastoid Lift)? | A Doctor Explains the Effects, Costs, and Duration
"What kind of effects does Botox Lift have?"
"Lately, my jawline seems to have become a little blurry."
"My mouth corners droop, and I feel it makes me look grumpy."
"Neck wrinkles make me look older than I am..."
Do you have any of these concerns about Botox Lift?
Hello. This is Smart Skin Clinic, an aesthetic dermatology practice.
In this article, a cosmetic dermatology clinic performing over 10,000 injectable procedures a year offers a careful explanation of the key points you may be wondering about—including Botox Lift's effects and duration, how it works, downtime and risks, how to think about pricing, and how it compares with other treatments.
Group Chief Director, Smart Skin Clinic Group
Ishii Kota
Career
Graduated from Juntendo University School of Medicine
Worked at Tokyo Women's Medical University Hospital and affiliated facilities
Worked at a major aesthetic clinic in Tokyo
Affiliations / Qualifications
Board-certified specialist, Japan Surgical Society
Board-certified specialist, Japanese Society of Anti-Aging Medicine
*If you already know what you are looking for, you can jump straight to the relevant section using the table of contents below.
What Is Botox Lift?
Let us explain what the Botox Lift procedure involves, including how it differs from other Botox treatments.
Overview of Botox Lift
Botox Lift is,into the neckan injectable treatment in which small amounts of botulinum toxin (commonly known as Botox) are injected to naturally refine neck wrinkles, sagging along the jawline, and drooping mouth corners..
It targets the platysma muscle, which spreads from the jawline down to the neck, as well as the muscles that pull the corners of the mouth downward (such as the depressor anguli oris). It is well suited to those who wish to look more youthful and achieve a slimmer-looking face.
It is characterized by a short treatment time and relatively little downtime.
Botox Lift may be called by various names depending on the clinic.
These essentially refer to the same, or a very similar, procedure.
- Botox Lift: A common name widely used in Japan
- Lift-Up Botox: A name that expresses its effect in an easy-to-understand way
- Platysma Botox: A name that focuses on the platysma, the main muscle it acts upon
- Nefertiti Lift: A term often used overseas for an injection method that defines the jawline. It is named after the sharp, beautiful jawline and long neck of the ancient Egyptian queen Nefertiti.
How Botox Lift Works
Botox works by suppressing the release of the neurotransmitter acetylcholine, temporarily weakening the contraction of facial muscles.
The face and neck contain muscles that lift the face upward (elevator muscles) and muscles that pull it downward (depressor muscles), and these work in balance with one another to create our complex facial expressions.
The formulation is injected into the intradermal to superficial muscle layer,and by relaxing the excessive tension in the downward-pulling muscles (the platysma and depressor anguli oris), the upward-pulling muscles (the elevators) can work more freely, so the corners of the mouth appear lifted and the facial contours look lighter.This leads to a lifting effect.
Regarding the efficacy of type A botulinum toxin for platysmal prominence (PP), research findings report "a significant improvement in severity by day 14 (with significant improvements also in satisfaction, the perceived visual bother of the jawline and neck bands, and psychosocial impact), adverse events comparable to placebo, and no reported cases of dysphagia or muscle weakness."
For more details about the ingredients and effects of Botox, please see this article.
Anatomical Key Points: The Continuity of the Platysma, Depressor Anguli Oris, and SMAS with the Face-to-Neck Contour
The key to understanding Botox Lift lies in the continuity of the muscles and fascia.
The following relationships are particularly important.
- Platysma: A thin muscle that spreads from the neck to the lower face. The vertical bands (platysma bands) that appear when it is tensed contribute to laxity of the chin and jawline.
- Depressor anguli oris: The muscle that pulls the corners of the mouth diagonally downward. When overactive, it contributes to a downturned mouth and marionette lines.
- SMAS (Superficial Musculoaponeurotic System): A supporting structure that runs continuously from the face to the neck. It connects with the platysma, so tension in the neck is transmitted to the facial contour.
The key point is that these are not independent but continuous.
The downward pull of the platysma is transmitted to the cheeks and jawline via the SMAS. Those who spend long hours looking down at desk work, or who clench their teeth strongly, are prone to excessive tension in the depressor muscles and therefore tend to be good candidates.
By relaxing the tension of the platysma, the downward force on the SMAS is released, reducing the overall sense of sagging across the face.of the series.
Differences from Conventional Botox Injections
| Item | Conventional Botox | Botox Lift |
| Injection depth | Intramuscular | Intradermal to superficial muscle layer |
| Injection volume | Relatively large | Small amounts over a wide area |
| Main effects | Improvement of expression lines | Lift-up |
| Effect on expressions | Yes | Minimal |
Botox Lift suppresses the "downward pull" of the depressor muscles, aiming for a relative lifting effect on the mouth corners, jawline, and neck.
On the other hand,Conventional Botox injections work by weakening the contraction of specific muscles to improve expression lines.
For more about Botox, please see the article below.
The Difference from Skin Botox (Micro Botox)
| Item | Botox Lift | Skin Botox |
| Injection depth | Intradermal to superficial muscle layer | Dermis to fascia surface |
| Injection volume | Small amounts over a wide area | Small amounts over a wide area |
| Main effects | Lift-up | Skin-texture improvement, pore refinement, and sebum control |
| Effect on expressions | Minimal | Minimal |
Botox Lift acts on the superficial muscles, suppressing the downward pull to achieve a relative lifting effect.
On the other hand,Skin Botox mainly acts on the sebaceous glands, sweat glands, arrector pili muscles, and superficial fibers to refine skin texture and pores.
For more about Skin Botox, please see the article below.
Effects You Can Expect from Botox Lift
- Refining the jawline
- Rejuvenating the neck and neckline
- Lifting the corners of the mouth
- Secondary benefits for pores and sebum
Refining the jawline
By gently relaxing the platysma's downward pull on the jawline,the sagging contours become tighter and take on a sharper impression.The area from below the chin to in front of the ears (the lower jawline) can look less heavy, and as a result you can expect a slimmer-looking face, with the shadow of the marionette lines from the mouth corners toward the chin also becoming relatively less noticeable. However, the actual amount of fat itself does not change.
Rejuvenating the neck and neckline
When the neck—where signs of age tend to show—and the line from the face to the décolletage are beautifully refined, you can regain a remarkably youthful overall impression.
Botox Lift isIt relaxes the tension of the platysma bands to ease vertical wrinkles,and, through tiny multi-point injections into the intradermal to superficial layers,skin texture can become more refined and horizontal wrinkles can soften.This may occur.
Lifting the corners of the mouth
When the depressor anguli oris is strong, it can cause drooping mouth corners and a sullen-looking expression.
With Botox Lift, thisweakening of the action of the depressor anguli oris can naturally lift the corners of the mouth for a brighter expression..
In addition, lifting the corners of the mouth may help make marionette lines appear shallower.
Secondary benefits for pores and sebum
Botox Lift isAs a secondary benefit, sebum and sweat secretion become more moderate, which can lead to skin-quality improvements such as tighter pores, less shine, and more even texture.can also be expected.
As the skin quality along the jawline and under the chin improves, a synergistic effect is created that makes the sense of tightening even more pronounced.
Who Botox Lift Is and Isn't Recommended For
| Who we recommend this for | Who we do not recommend this for |
| Those concerned about heaviness along the jawline Those whose mouth corners droop and who tend to look displeased Those concerned about horizontal or vertical wrinkles on the neck Those who are hesitant about surgery but wish to achieve a lifting effect Those who want a treatment with minimal downtime | Those with very pronounced sagging Those with a large amount of excess skin Those with a very large amount of fat Those at risk of a contraindication |
For those with very pronounced sagging, particularly when the cause is excess skin or an abundance of subcutaneous fat, Botox Lift alone may not provide sufficient results.
It is important to have an examination to determine the cause of your sagging and confirm whether the treatment is suitable for you.
Contraindications and Those Who Require Caution
- Pregnant or breastfeeding women: contraindicated because safety for the fetus and infant is not established; contraception is needed for 3 months after treatment
- Allergy to botulinum toxin: contraindicated for those with a history of previous allergy
- Neuromuscular disorders: contraindicated for those with myasthenia gravis, amyotrophic lateral sclerosis, or Lambert-Eaton syndrome
- Certain medications: caution is needed with aminoglycoside antibiotics and muscle relaxants
- Blood-clotting disorders: increased risk of bleeding
- Immunosuppressed state: the risk of infection must be considered
- Infection or inflammation at the injection site: reduced treatment effect and risk of spreading infection
- Under 18 years of age: best avoided, as safety is not established
For other details, please contact the clinic.
Treatment Flow
You can easily book from your smartphone.
You can reserve a date and time that suits you through our online booking system or by phone.
Both new and returning patients can book 24 hours a day.
A smart, effortless check-in: just give your name and our clinic IT system completes reception right away.
When you arrive, simply give your name at the reception desk for a smooth check-in. First-time visitors will be asked to complete a brief medical questionnaire.
During counseling, please feel free to share any concerns. Rest assured, there is no pushy sales.
After disinfection, we confirm the position by having you make an expression that tightens the mouth area to reveal the vertical bands of the platysma, then mark the sites.
Cooling or topical anesthesia is applied as needed.
After adjusting the number of units to your condition, we administer small amounts at multiple points, spaced roughly 1.0 to 1.5 cm apart, while checking in with you throughout.
Time required: approximately 10 to 20 minutes
We explain in detail how to care for the treated area and precautions for daily life.
We also suggest appropriate home care from the standpoint of prevention and maintenance, including oral medications and skincare products that may help address your concerns.
You can return to your daily activities immediately after the procedure. Makeup can be applied to the treated area from the following morning.
If you have any concerns, please feel free to contact us at any time.
Pain During Botox Lift and How We Address It
Because Botox Lift is an injection-based treatment, many people worry about how much it will hurt.
The treatment causes only a slight prickling sensation.A single injection is not unbearable, but when the treatment covers a wide area it may feel uncomfortable.
At our clinic, we take various measures to minimize your discomfort as much as possible.
- Numbing cream (topical anesthesia)
- Cooling
- Ultra-fine needle
- Adjusting the injection speed of the formulation
Topical anesthesia (numbing cream) involves applying a cream containing a local anesthetic to the treatment area to dull sensation in the surface layer of the skin. Allowing enough time for it to absorb eases the prickling sensation during injection.
Cooling means thoroughly chilling the skin with a cold pack or similar just before injection. This suppresses pain signals and reduces the sensation of discomfort. By constricting blood vessels, it also helps lower the risk of bruising.
We use ultra-fine needles because thinner needles meet less resistance as they pass through the skin, making them less likely to cause pain. At our clinic, we select ultra-fine needles according to suitability.
Keeping the injection speed steady and slow reduces pressure pain and discomfort. We proceed at a comfortable pace while checking in with you throughout.
How pain is felt and how well anesthesia works vary from person to person. If you have any concerns, please do not hesitate to let us know.
Downtime, Side Effects, and Risks
Common Downtime Symptoms and How to Manage Them
- Symptoms: swelling, redness, and mild pain at the injection site
- Duration: several hours to a few days
- How to manage: cooling (for pain and bruising); makeup (for redness and bruising)
There is little to no impact on daily life.These symptoms are temporary and ease over time.
After treatment, you may feel a mild, muscle-ache-like soreness, a sense of tightness, or discomfort, which typically settles within a few days to about a week. Redness and stinging usually ease within 24 to 48 hours at most. Mild swelling, puffiness, and tenderness generally settle within a few days.
Bruises first appear purple and gradually turn yellowish as they fade, usually being absorbed and disappearing within about one to two weeks. Most are light enough to conceal with makeup, butbecause they can occur over a wide area, it is best to plan your treatment with neck exposure and lifestyle in mind..
Applying moderate cold to the treated area may help ease pain and prevent bruising.
Risk｜Changes in Expression and Restricted Movement
Because Botox is a drug that inhibits muscle movement, depending on how the effect develops, changes in facial expression may occur.
If it works too strongly
If overdosing causes the drug to spread beyond its intended area, it may lead to difficulty swallowing or weakened neck muscles, and it may also spread to the submandibular glands, causing dry mouth. To prevent this, our clinic recommends starting with a slightly conservative dose and adding more later if needed.
The effect of Botox Lift peaks around one month later and then gradually subsides.
If the effect is weak
Because muscle strength varies from person to person, the planned number of units may sometimes feel insufficient. In that case, we can assess your condition from two weeks or more after treatment and make adjustments with additional injections.
If asymmetry appears
If the product spreads to the depressor labii inferioris due to overdosing, it can lead to an asymmetrical smile. Should noticeable asymmetry develop after treatment, additional injections can be used to restore balance.
If you notice any concerning changes in your expression, please do not judge on your own—be sure to consult the clinic where you had the treatment.
Rare complications
Although very infrequent, the risk of complications such as the following is not zero.
Allergic reaction
You may develop an allergic reaction to the ingredients contained in the Botox formulation.
If you experience symptoms such as severe redness, swelling, itching, or hives, please contact the clinic immediately.
Infection
In very rare cases, bacteria may enter through the injection site and cause an infection. If the injection site becomes red and swollen and heat or pain persists, it may be a sign of infection.
As treatment will be necessary, please contact the clinic.
Aftercare｜What You Can Do to Enhance the Results of Botox Lift
- Do not touch, rub, or press on the area immediately after treatment
- Refrain from activities that increase circulation (vigorous exercise, saunas, long baths, alcohol) for a certain period
- Step up moisturizing and UV protection
- Measures against teeth clenching
- Avoid a downward-facing posture
- Review lifestyle habits such as sleep, nutrition, and smoking cessation
Basic Rules from the Day of Treatment Through 48 Hours
- Do not touch, knead, or press the treated area more than necessary
- Keep the area clean; wash your face with lukewarm water / use gentle skincare / blot with a towel to remove moisture rather than rubbing
- Limit cooling to short periods only when needed / do not apply ice directly
Impact on Daily Life
- On the day: showering is fine
- The next day: makeup is fine from the following morning
- For about one week: avoid saunas, long baths, and strenuous exercise
Keeping the above in mind helps your recovery go smoothly and makes it less likely that the results will be hindered.
Advantages and Disadvantages of Botox Lift
| Benefits | Drawbacks |
| Can be treated without surgery Short treatment time Little to no downtime Natural-looking change | The effects are not permanent It takes time for the effect to appear Requires regular treatment Involves long-term costs |
Duration of Effect and Maintenance
Once you have the treatment, when do the effects appear and how long do they last? This is one of the points people most want to know.
- When results appear: about one week later
- Peak effect: approximately one month later
- Duration of effect: about 3 to 6 months; not permanent
- Recommended treatment interval: every 3 to 6 months
The effects of Botox are not permanent.
Over time, muscle movement gradually returns and the effect slowly weakens. The duration varies from person to person, depending on muscle strength and lifestyle.
Signs it may be time to consider your next treatment
- When you feel your jawline has started to return to how it was
- When you begin to feel your mouth corners drooping
To maintain the results, it is ideal to have your next treatment before the effect completely wears off and things return to their original state.
That said, we do not recommend having treatments frequently at intervals shorter than three months just to prolong the effect. This is because it may raise the risk of developing antibodies, which can make the treatment less effective. Always follow your physician's instructions.
How Fees and Units Work
The cost of Botox Lift varies from clinic to clinic. Let us look at why prices differ and how fees are determined.
Main Factors That Affect the Price
- Type of formulation used: whether or not it is an approved drug, and differences in cost
- Characteristics of the treatment area and the number of units needed: muscle strength and degree of sagging
- The clinic's policies and setting: aftercare, location, and advertising costs
Rather than choosing on low price alone, it is important to weigh these factors together and select a medical institution you can trust.
Guide to the amount injected (units)
The physician observes how you move your facial expressions to decide which muscles to treat, at what depth, and how much to inject.
The amount of botulinum toxin is expressed in "units," and the number of units used also affects the cost. For Botox Lift, the typical guide is around 40 to 80 units.At our clinic, the price for Botox Lift is clearly stated based on 40 units.
Comparison with Other Aesthetic Treatments and Whether They Can Be Combined
There are various options besides Botox Lift for treating sagging. Here we explain how it differs from representative treatments and whether they can be combined.
| Treatment | Main indications | Mechanism of action | Duration | Pain | Downtime | Combined use |
| Botox Lift | Mild to moderate sagging, neck wrinkles, drooping mouth corners | Suppresses muscle action to lift | 3-6 months | Mild | None to a few days | ◎ |
| Jaw Botox | A prominent jawline | Atrophies the masseter muscle | 3-6 months | Mild | Almost none | ◎ |
| Thread Lift | Moderate sagging, nasolabial folds, marionette lines | Physically lifts the tissue with thread | 1 to 2 years | Moderate (local anesthesia is used) | 1 to 2 weeks | 〇 |
| HIFU | Sagging, skin tightening | Contracts the SMAS with thermal energy | Six months to one year | Mild to moderate (varies by area treated) | None to a few days | ◎ |
| Facelift surgery | Severe sagging, excess skin | Lifts the SMAS and removes excess skin | 5 to 10 years | Strong; local anesthesia | 1 month onward | △ |
Jaw Botox
This is also a Botox injection, but its purpose is to shrink the masseter (jawline muscle) for a slimmer face. It is suitable when the cause of a heavy jawline is "muscle development."
Combining it with Botox Lift (platysma) can help you aim for a sharper contour.
For more about Botox injections, including Jaw Botox, please see the article below.
Thread Lift
This treatment inserts special barbed threads under the skin to physically lift sagging tissue. It offers a more direct lifting effect than Botox Lift, but tends to involve longer downtime.
When combined with Botox Lift, the threads lift the tissue while Botox suppresses the downward vector, so you can expect a synergistic effect.
For more about thread lifts, please see the article below.
HIFU (High-Intensity Focused Ultrasound)
This is a "non-surgical facelift" that delivers ultrasound energy to the SMAS fascia and tightens it with heat. It can provide tightening from the underlying foundation.
Because it works on a different layer than Botox Lift, the two are highly compatible. A popular combination is tightening the foundation with HIFU and refining the surface lines with Botox Lift.
Facelift surgery
This is a surgical procedure that lifts the SMAS fascia and removes excess skin.
It is the most fundamental and highly effective treatment for sagging, but it involves long downtime and a risk of scarring.
It is suitable for those with severe sagging.
FAQ
- How much does it hurt? Is anesthesia necessary?
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It feels like a light prickling sensation. We provide pre-treatment cooling and numbing cream, so you can feel at ease.
- Is there any downtime? Do I need to take time off work?
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Downtime is minimal and no rest period is needed. Bruising occurs only rarely, and when it does it is light enough to conceal with makeup. You can wear makeup from the day after your treatment.
- How many units of Botox Lift are usually needed?
-
The typical range is 40 to 80 units, but the ideal amount varies from person to person depending on the condition of your face. Your physician will recommend the appropriate amount after examining you.
- When will I start to notice the effects?
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Effects begin to appear about one week after treatment and reach their peak around one month later.
- Is there any effect even after just one session?
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Yes, you can experience a lifting effect even after a single treatment.
- How long do the effects last, and how often should I have the treatment?
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The effects typically last about 3 to 6 months. To help maintain the results, we recommend continuing treatment.
- Can it be combined with other treatments?
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Yes, it can be combined with thread lifts and HIFU. Please consult your physician about the best combination for you.
- Can I have the treatment while pregnant?
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No. Because safety has not been established for those who are pregnant or breastfeeding, we are unable to provide this treatment.
- Can men also have Botox Lift?
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Yes. However, because men tend to have greater muscle mass, they may require a higher number of units than women.
Key Points for Choosing a Clinic
To achieve satisfying results with Botox Lift and avoid feeling that it "failed," there are points we would like you to be aware of yourself.
- Do they have a high number of cases? Are the reviews favorable?
- Is the price fair?
- Is the formulation being used appropriate?
- Were you given an explanation of whether you are a candidate for Botox Lift?
- Were you able to share your desired outcome with the physician?
- Did you find the explanation of the appropriate number of units convincing?
- Were you properly informed not only of the benefits but also of the downtime, risks, and side effects?
- In the unlikely event that something happens, can you consult someone right away?
Choosing a trustworthy clinic and physician who meet all of these points is the most important key to avoiding disappointment.
Types and Characteristics of Botulinum Toxin Preparations
"Botox" is in fact the product name of Allergan's formulation. Although it is used almost as a generic term, botulinum toxin preparations are actually manufactured and sold by various makers.
Smart Skin Clinic offers two preparations: "Botox Vista®" and "Botulax."
Both can deliver ample results when used appropriately, but they differ in their approval status and characteristics.
At our clinic, the physician listens to your concerns and wishes during the consultation and proposes the most suitable preparation.
Botox Vista® (Allergan Inc. / USA)
This is the only formulation in Japan approved by the Ministry of Health, Labour and Welfare for glabellar lines and crow's feet.
With a long track record around the world,it offers high reliability in both safety and efficacyThis is its hallmark. It is recommended for first-time patients and for those who place the highest priority on safety.
Reference:Botox Vista
Botulax (Hugel Inc. / Korea)
This preparation is approved by South Korea's MFDS (formerly KFDA) and is an unapproved drug in Japan.
Developed with Botox Vista® as a reference, positioned much like a generic,is chosen by those who value cost-effectivenessis chosen by such patients.
Reference:Hugel Inc.
Details
| Item | Contents |
| Treatment Time | Approximately 5 to 20 minutes (excluding counseling) |
| Recommended Number & Frequency of Treatments | Treatment is recommended at intervals of approximately 3 to 6 months |
| Downtime | A few hours to a few days |
| Treatment on the day of counseling | Available |
| Makeup | Recommended from the following morning onward to help prevent infection |
| Skincare | Possible right after the treatment |
| Shower | Possible from the same day |
| Pain | A slight pricking sensation when the needle is inserted. |
*Individual results may vary.
Legal Notices
Botox injections include treatments using drugs not approved in Japan. The drugs used in treatment are imported personally at the discretion of our clinic's physicians.
Please refer to this page for information on medications and similar items that require caution in personal importation.
Ministry of Health, Labour and Welfare,Medicines and Other Items Requiring Caution in Personal Importation"
For Botox Lift, choose Smart Skin Clinic
Botox Lift is an injectable treatment that can naturally lift sagging from the jawline down to the neck.
However, depending on the degree of sagging, other treatments may be more suitable.
"Can my sagging be improved with Botox Lift?" "Exactly how much will it cost?" If you have questions or concerns like these, please come in for a free consultation at our clinic.
Smart Skin Clinic performs over 10,000 injectable procedures a year. Our pricing is transparent, with unnecessary costs eliminated. We use drugs approved by the Ministry of Health, Labour and Welfare or by public agencies overseas.
Having a consultation never means we will pressure you into treatment. Our experienced physicians will carefully examine the current condition of your face and recommend the treatment plan best suited to you.
Reference
Clinic List
Jimbocho Clinic
〒101-0054
3-16-1 Kanda Nishiki-cho, Chiyoda-ku, Tokyo, EX Kanda Nishiki-cho Building 8F (general reception) / 7F
Hours: Mon–Fri 11:00–20:00 / Sat & Sun 10:00–19:00
Yokohama Clinic
〒221-0835
TS Plaza Building 2F, 2-23-2 Tsuruya-cho, Kanagawa-ku, Yokohama-shi, Kanagawa
Hours: 10:00–19:00
About the physician supervision of this site
This site is operated under the supervision of a Smart Skin Clinic supervising physician.
This page was produced in accordance with the Medical Advertising Guidelines Medical Advertising Guidelines revised and enforced in June 2018, under which we produce and provide this information.
- Scope of supervision: treatment descriptions, risks and side effects, price display
- Last supervision date: June 26, 2025