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It’s the Summer of Barbie … Botox?

— What’s up with the neck-slimming procedure known as Barbie Botox?

by
Rachael Robertson, Enterprise & Investigative Writer, MedPage Today

Welcome to Culture Clinic, MedPage Today‘s collaboration with Northwell Health to offer a healthcare professional’s take on the latest viral medical topics.

“Barbie Botox,” also known as trap Botox, has existed for years but Google Trends data revealed that searches for “Barbie Botox” skyrocketed in early July, coinciding with the extensive promotion campaign for the “Barbie” movie, while searches for “trap Botox” peaked in April and still remain high.

The procedure involves injecting about 40 units of onabotulinumtoxinA (Botox) into each trapezius muscle. Roughly 3 weeks later, the full effects result in atrophied trapezius muscles, giving the illusion of a longer “Barbie-like” neck. The injection also helps muscles to relax, and may improve posture and neck/shoulder stiffness and pain.

TikTok content creator Isabelle Lux posted a video in mid-June — which now has more than a quarter million views — touting the benefits of trap Botox and was one of the first to coin it “Barbie Botox.” She said she got the procedure after being blown away by her friend’s results and wanted the same look for her upcoming wedding. She posted the video a day after the procedure, chatting in front of a “Barbie” movie poster, and has since posted updates of her results.

Barbie Botox Isn’t Suitable for All

Scrolling through videos tagged #BarbieBotox, the reviews are glowing, with few indicators that the procedure is anything but desirable. Women, mostly in their 20s and 30s, post their before and after results in which their trapezius muscle is visibly smaller after a few weeks.

However, Raman Madan, MD, a dermatologist at Northwell Health in Huntington, New York, told MedPage Today that not everyone is a good candidate for Barbie Botox.

“You don’t want to do it on every patient that comes in asking for it, because there can be downsides if you pick someone who has naturally weakened trapezius muscle,” he explained. “I think that’s the biggest takeaway.”

“It’s not a completely risk-free procedure,” he added.

For instance, if someone already has small trapezius muscles, Barbie Botox could cause the patient undue weakness, as can injecting in the wrong place or using too many units of Botox.

Though Madan acknowledged that the trapezius muscles are relatively safe in terms of places where people get Botox injections, he doesn’t recommend Botox for anyone under 21, with a few exceptions for medical treatment — not because it’s dangerous but rather because “it’s a little overkill.”

As Botox works by stopping a muscle, “you’re not moving the muscle as much … and if you don’t use it, you lose it and it starts to shrink a little bit. That’s how [Barbie Botox] gives the appearance of basically having a longer neck — by making the muscle look smaller,” he explained.

As the trapezius muscle atrophies, he said that “you might notice a little weakness, but your day-to-day activities shouldn’t change too much.”

Barbie Botox results, like any Botox procedure, are temporary, lasting about 6 months. Madan noted that bodies recognize Botox as a toxin, which is cleared over time.

“Basically, once the Botox stops working, the nerve connection allows you to move the muscle more. And the more you start to use it, it builds back up,” he said. “It’s the same way as if you’re not working out for a while. If you go back to the gym and you start working out, [muscle] starts coming back.”

Steep Cosmetic Price Mark Up

The procedure is not cheap. Insurance only covers Botox injections in certain locations as medical treatment for conditions such as migraine or excessive sweating. Barbie Botox costs upwards of $1,200 and is not covered by insurance.

“A big chunk of the price comes from just the actual cost of the Botox itself,” Madan said. Plus, since it’s off-label usage for Botox, patients have to pay private cosmetic prices, regardless of whether they get the procedure to relieve tension or for an enhanced silhouette.

The TikToker Lux told CNN that her procedure was gifted to her by a booking app for aesthetic appointments.

While Madan is seeing a surge in people seeking trap Botox, he pointed out that trends in cosmetic procedures come and go. A few years ago, “micro Botox,” which uses smaller amounts of Botox for more subtle anti-aging effects, was all the rage, he noted.

According to 2021 data from the International Society of Aesthetic Plastic Surgery, the top non-surgical medical procedure for both men and women globally involved botulinum toxin, with most procedures occurring in the U.S.

  • author['full_name']

    Rachael Robertson is a writer on the MedPage Today enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts. Follow

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