Revised Training Guidelines for Nefertiti Lift Procedures
Dear Juv'ae nurses,
Following recent discussions with Dr. Goodman and Allergan regarding the administration of botulinum toxin for the Nefertiti lift procedure, it has been determined that the maximum starting and maintenance dose should be capped at 50 units per treatment session. This decision is based on clinical evidence indicating that higher doses may increase the risk of adverse effects.
Background:
The Nefertiti lift targets the platysma muscle to achieve a more defined jawline and smoother neck appearance. While previous training under Dr. Jimmy Wang included dosages up to 100 units, emerging studies suggest that such high doses may not significantly enhance efficacy and could elevate the risk of complications.
Clinical Evidence:
- Recommended Dosage:
- A study published in Plastic and Reconstructive Surgery – Global Open indicates that starting doses typically range from 10 to 30 units for women and 10 to 40 units for men, depending on band thickness. The total dose generally ranges between 40 to 100 units for effective treatment. However, it is crucial to note that higher doses do not necessarily correlate with better outcomes and may increase the risk of adverse effects.
- Adverse Effects Associated with Higher Dosages:
- Research indicates that administering doses above 50 units in the neck region can lead to complications such as neck weakness and dysphagia. These adverse effects are attributed to the diffusion of the toxin into adjacent muscles involved in swallowing and neck movements.
Revised Guidelines:
- Maximum Dosage: Effective immediately, the total dose of botulinum toxin for Nefertiti lift procedures is capped at 50 units per treatment session.
- Injection Technique: Administer injections intramuscularly into the platysma bands, ensuring precise placement to minimize diffusion to adjacent muscles. It is recommended to inject 2- 3 units per point, with each point spaced approximately 1 to 2 centimeters apart.
- Patient Assessment: Evaluate each patient's anatomy and muscle activity to tailor the injection plan appropriately. Consider factors such as band prominence and skin laxity when determining the exact dosage and injection sites.
Conclusion: The decision to cap the botulinum toxin dose at 50 units for Nefertiti lift procedures aligns with current clinical evidence aimed at maximising patient safety while maintaining treatment efficacy. All Juvae trainers are required to adhere to these updated guidelines in their practice to ensure consistent and safe patient outcomes.
Please update your training materials accordingly and ensure that all nurses you have trained above 50 units are informed of these changes.
For further information or clarification, feel free to contact me directly.
References:
- Rohrich, R. J., & Janis, J. E. (2020). Effective Treatment of Platysma Bands with Neurotoxin. Plastic and Reconstructive Surgery – Global Open, 8(6), e2965.
- Yi, K.-H., Lee, J.-H., & Kim, H.-J. (2022). Anatomical Proposal for Botulinum Neurotoxin Injection Targeting Platysma Muscle. Toxins, 14(12), 851.
- Kordestani, R. K., & Chung, T. L. (2015). Botulinum Toxin-A Chemical Denervation for Platysmal Bands: Maximal Dosing Considerations. Journal of Drugs in Dermatology, 14(9), 931-932.
By adhering to these updated guidelines, we can continue to provide safe and effective treatments for our patients.