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The new "Barbie Botox" on TikTok? Where's Ken

I don't believe in all this phony crap that produces only cosmetic results. I'll stick to Anabolic steroids.



What Is ‘Barbie Botox’? The New Injectable Trend Taking Over TikTok

Patients are asking to have Botox injected in their trapezius muscles, in the hopes of reducing pain and achieving longer-looking necks. Dermatologists say demand is way up.


By Adrienne Matei, WSJ

Aug. 29, 2023 2:13 pm ET



Isabelle Treuille, a 32-year-old influencer in Palm Beach, Fla., tried everything to fix the chronic muscle tension in her neck.


“Stretching my pecs, stretching my back. Yoga. Pilates. Any kind of exercise that can strengthen deep muscles,” she said. “Regular massages. I’ve tried acupuncture. I’ve tried cupping.”


Unable to turn her neck to look over her shoulder, Treuille considered getting a frenectomy, an oral surgery that doctors say may reduce upper back tension. But first, she decided to try a less-invasive procedure she’d learned about on TikTok: 40 units of Dysport injected on either side of her trapezius muscle, in the dense triangles of tissue between her shoulders and neck.


Doctors have long used wrinkle-diminishing neurotoxins such as Dysport and Botox off-label to treat pain by partially paralyzing and relaxing certain muscles. Now, trapezius-muscle Botox—commonly known as “Barbie Botox” and “trap tox”—has become a cosmetic trend in the U.S., thanks to social-media posts by influencers and providers who say the treatment can also create the illusion of a slender, elongated neck. Injectors, plastic surgeons and cosmetic dermatologists are seeing spikes in patients asking for the injections for both pain relief and aesthetic reasons.


A spokesperson for Allergan, the maker of Botox, declined to comment. Galderma, the maker of Dysport, didn’t respond to a request for comment.




Influencer Isabelle Treuille before (left) and 30 days after receiving a treatment she calls ‘Barbie Botox.’ PHOTO: ISABELLE TREUILLE


Treuille, a TikTok influencer, partnered with Dr. Alonso Martin, an injector in Miami Beach, Fla., in June. He injected her with $1,500 of Dysport in exchange for her making content about the procedure. “Your typical influencer marketing,” Martin said of the deal. He said he works with three influencers a month on similar promotions for various treatments.


“Demand has surged significantly,” said Martin, who is now seeing eight to 10 trap-tox patients a week. He said he previously saw between four and six annually.


After the treatment, Treuille said she was pleased with her improved mobility and pain relief. She also said her shoulder muscles had shrunk, making her neck look slimmer and longer. “That was really a bonus in terms of my wedding coming up and how I would look in my dress and my pictures and videos,” she said. She tagged her TikTok videos #BarbieBotox—her own coinage, referencing the doll’s physics-defying neck—and watched them take off.


Dr. Ava Shamban, a celebrity dermatologist in Beverly Hills, Calif., said she is suddenly fielding around five inquiries a week for the once-niche procedure. She offered an analogy for how it works.


“You can just almost imagine like your neck is sitting on a pillow,” she said. “You take out some feathers, and it shrinks down.” That creates the appearance of a longer neck, she said.


Shamban charges $2,100 for 100 units of Botox. In the U.S., the procedure ranges in price from around $900 to $3,000. Doctors say results start to kick in after four weeks and last on average six to eight months.


Where Manhattan cosmetic dermatologist Dr. Shereene Idriss once saw under five trap-tox patients a month, she’s now seeing about 15, mostly women aged from their early 20s to early 30s. (Men tend to want bigger traps.) Her office charges $1,075 for 100 units of Botox, though some patients may require more or less.


“Sixty to 70% of why people come in is cosmetic purposes, but they always end up hinting at the component of pain and tension,” said Idriss.


Treuille said 80 units yielded life-changing effects. In addition to her reduced pain and longer-looking neck, she said she felt her posture had improved thanks to other muscles in her body compensating for her frozen traps.


Dr. Gregory A. Greco, president of the American Society of Plastic Surgeons, said he didn’t see how injections in the trapezius could affect posture. “I can’t imagine that 50 or 100 units of Botox in the upper trapezius have anything to do with your abdominal musculature,” he said. “I think that’s some very weak science.”


While social-media posts about cosmetic treatments can suggest that they are one size fits all, in fact experiences may vary.



Amanda Chan, a 31-year-old, Melbourne-based designer, traveled to Seoul for 150 units of Botox in her traps. In South Korea, a country often ahead of the curve with aesthetic trends, the trapezius is a popular neurotoxin injection site second only to the face. Chan said she hasn’t seen results two months after her injection. “I guess I was hoping for a drastic difference,” she said. She’s open to trying again.


Last year, Luissa Chekowsky, 50, of upstate New York pursued trap tox to help with medical conditions including cervical dystonia, a painful neck spasming. A doctor she had been seeing for 12 years injected her with a cautious, reduced dose of neurotoxin—55 units rather than the minimum 150 typical for treating the condition. Three days after the injection, Chekowsky says she lost her ability to swallow anything but liquids. She spent seven weeks trying to find a doctor who could tell her what had happened and whether it would be permanent.


“‘Oh, your larynx is totally frozen on the right side,’” she recalled a provider finally telling her. The condition, called dysphagia, is a known side effect of Botox, but one so unusual that most of Chekowsky’s doctors had simply never seen it.


“The risk of dysphagia, although it is rare, is real,” said Greco. “Often it’s related to migration of the toxin, either into the side or front of the neck area, to the spot some of the swallowing muscles come into play,” he said.


Regarding whether she worried her TikToks could steer people toward potential harm, Treuille said she always advises caution: don’t try to save money, and stick to your doctor’s guidance. “I like to remind people that there are always risks,” she said. “I fear sometimes just for even one individual who would have a bad result as a result of me.”


Chekowsky has recovered from her side effects. But this summer, when she saw the hashtag #BarbieBotox trending on TikTok, “my heart sank,” she said. She doesn’t judge anyone for seeking the treatment, whether for cosmetic or medical reasons, nor does she blame her provider for what happened, she said.


“I think where it goes a little wrong is there’s not enough information that’s being placed in front of people when they’re making these decisions,” she said.

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