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What is Trap Tox or “Barbie Botox”?

Barbie head poking out from fur material blanket

Is there anything that tox isn’t used for these days? This amazing product has many applications, including wrinkle treatment, reduction of sweating, muscle spasms, migraine relief, and overactive bladder. Now, there’s yet another use: a procedure known as “trap tox” or “Barbie Botox.” This treatment is gaining plenty of attention on social media – particularly TikTok – and celebrities the world over have had it done. Trap tox proponents rave about the procedure’s ability to elongate the neck and shoulders by reducing bulk in the area. But what does it involve? We’ve got the skinny on trap tox here.

First Things First: What Is Tox, Commonly Known as Botox?

Before explaining what’s involved in a “Barbie Botox” treatment, it’s essential to understand how tox works. It is a neurotoxin produced in nature by a bacterium known as Clostridium botulinum. And yes, if you’re wondering, clostridium botulinum can cause a severe and potentially deadly foodborne illness known as botulism. However, when the toxin is produced, purified, and packaged in exacting doses, it is incredibly safe and effective when used as a cosmetic treatment. Injected via a small needle, it blocks nerve signals from in the face, and after 3-14 days, the muscle can no longer contract, causing wrinkles to soften or disappear. The effect lasts 3 to 6 months depending on the type of toxin used (and the individual metabolism of the client) after which the treatment must be repeated.

Fun Fact: Dogs Are Immune to Botulinum Toxin.

Botulinum toxin is also used non-cosmetically to treat a variety of medical conditions. For example, it can be injected into the underarm area to treat hyperhidrosis (excessive sweating), and can also be used to treat migraines, and has applications for overactive bladder and other muscle spasm. The tox helps by inactivating the muscles in these areas to relieve tension.

How Does Trap Tox Work?

Trap tox is named for the trapezius muscle, where the procedure is focused. This trapezoid-shaped muscle runs from the back of the head, through the tops of the shoulders, and into the scapula (shoulder blade) area. Some people have bulky trapezius muscles, either from working out or by natural anatomy. Poor posture and sitting in a hunched position (as at a desk) can also enlarge the trapezius muscles. When these muscles are bulky, they tend to create the appearance of a shorter neckline and larger shoulders. Injecting toxin into these muscles can relax and elongate the area, giving it a slimmer appearance – hence the alternate name of “Barbie Botox.” (Most trap tox patients are women since bulky shoulders are often considered more desirable in men.)

What’s Involved in a Trap Tox Procedure?

Your doctor or injector will prepare your skin. Rarely, a topical numbing treatment on the skin is used to reduce pain, though it’s not typically needed (and makes the treatment take longer). Your injector will use a small needle to inject tox strategically into the trapezius muscles. The entire procedure takes just a few minutes in the office. The amount of tox injected varies from person to person and depends on your shoulder anatomy and the look you want to achieve; Doses from 20-40 units per side are commonly required.

After the procedure, it will take some time for the tox to take effect. This largely depends on the brand of toxin used (Jeuveau is somewhat faster-acting than BOTOX, for example). This ranges from 3-14 days (usually 7-10 days). It can take about two weeks before you start noticing slimmer shoulders. As with toxin for wrinkles, the effects of trap toxins aren’t permanent. You must repeat your treatment every 4 to 6 months to maintain the look.

Are There Medical Uses for Trap Tox?

Trap tox could relieve your neck and shoulders of significant tightness that won’t go away with stretching or hot baths. Relaxing the muscles in that area could help with muscle knots, spasms, trigger points, posture, neck and back pain, and headaches. Trap tox may also be effective at reducing migraines. If you think you have a medical condition that warrants the use of trap tox, talk to your doctor and see if it could be a good option for you.

What Are the Side Effects of Trap Tox?

After treatment of the trapezius, you may be bruised and sore for a few days. You may also get headaches or find that the injection area itches. If these symptoms last longer than a few days, contact your doctor to let them know.

If Botox is administered improperly, other side effects are also possible. For example, accidentally injecting muscles outside the trapezius can cause weakness in those muscles – such as those that turn your head from side to side. Injecting too much botulinum toxin can also cause shoulder weakness. When considering any treatment with toxin, please consult with a medical doctor like Dr. Boger beforehand so a full assessment of your specific situation can be made.

Who Should Not Get Trap Tox?

The contraindications for the procedure are much the same as those for any other kind of tox treatment. If you are allergic to botulinum toxin, you should, of course, avoid it. People with neuromuscular disorders or who are pregnant, or breastfeeding should also forego the procedure. Certain medications that act on the nervous system, such as calcium channel blockers, may also make tox a less-than-ideal treatment. If you are prone to keloidal scarring (thick, raised scars after you cut yourself), be sure to discuss with your doctor whether trap tox is aesthetically appropriate for you.

The Bottom Line

Trap Tox or Barbie Botox is more than just a fad. There are medical indications for its use as well. If you are considering Trap Tox, be sure to speak to a qualified and knowledgeable medical doctor and injector like Dr. Boger who understands the anatomy of the body and can offer a treatment plan that is best tailored to the results you expect.