Q&A: What clinicians should know about viral beauty trend ‘Barbie Botox’

Key takeaways:

• “Barbie Botox” is the social media nickname for trapezius Botox.
• Clinicians must manage the expectations of patients who are considering this cosmetic procedure.

Following the release of the “Barbie” movie in July 2023, a new cosmetic trend called “Barbie Botox” has taken social media by storm.

Better known by clinicians as trapezius Botox, Barbie Botox is a procedure that is done for practical reasons but may also come with aesthetic benefits. These benefits include elongating the neck and shrinking the shoulders — a look that social media influencers claim imitates the widely-known Barbie doll.

According to Forbes magazine, the hashtag #barbiebotox has recently surged in popularity, reaching 9.4 million views on TikTok, and the hashtag #traptox has reached 22.5 million views on the platform.

To learn more about the details of this popular cosmetic trend and how clinicians should respond to it, Healio spoke with Lara Devgan, MD, MPH, FACS, an attending plastic surgeon at Lenox Hill Hospital, Greenwich Hospital and Manhattan Eye, Ear & Throat Infirmary, CEO of Dr. Devgan Scientific Beauty and chief medical officer of RealSelf.

Healio: What are legitimate reasons that people would get trapezius Botox prior to it becoming a viral trend?

Devgan: Patients get trapezius Botox for both functional and aesthetic reasons. On a functional level, relaxing the superior border of this large kite-shaped muscle in the back can reduce tension, shoulder aches, headaches and migraines. This in turn provides pain relief for those who may find that their trapezius muscles are hypertrophic, overbuilt or in a tonic spasm.

In addition, relaxing these muscles can provide relief from chronic muscle tightness (giving relief from back/shoulder tension). This can also aid in posture improvement by relaxing the muscles and encouraging a more upright stance.

In terms of aesthetics, trapezius Botox works via disuse atrophy or controlled shrinking of the superior border of the trapezius muscle. This creates an elongated, swan-like appearance of the shoulder to neck junction— hence the nickname Barbie Botox.

Healio: Will getting trapezius Botox really create the “Barbie” look?

Devgan: Injecting a neuromodulator into the trapezius muscle allows patients to achieve a more defined and sculpted appearance in the neck and shoulder area. The chosen product reduces the appearance of bulkiness, creating a smoother contour and enhancing the appearance of the whole upper body.

Overall, the “Barbie look” is one of an elongated and smooth neck. Achieving a specific look would depend on factors such as individual anatomy, desired results, dosage injected and the expertise of the medical professional administering the injections.

Healio: What are the potential harms of getting Barbie Botox?

Devgan: Trapezius Botox is a safe and effective treatment with minimal risk for harmful side effects. When administered by a qualified, board-certified plastic surgeon, there is little risk for adverse events.

Appropriate attention to anatomy is of utmost importance. Because only a small portion of the muscle is being treated, there are no functional limitations in terms of exercise or other activities. Patients should anticipate being able to perform all of their normal functions.

With all injectables, there is a risk for redness, bruising, or transient irritation at the injection sites. This is expected to go away shortly after treatment, and it is not considered to be an adverse event, or a long-lasting sequela.

Expectation management is an important consideration after any cosmetic procedure. The most beautiful effects from trapezius Botox are seen over the course of months, as the mechanism of disuse atrophy is a long-term concept, and not an immediate short-term outcome. Patients who want instant gratification are likely to be disappointed. This is true of all plastic surgery, procedures, and body dysmorphia and unhealthy anchoring to unrealistic beauty standards must always be held in check.

Healio: What is your advice to other clinicians that have patients who are interested in this procedure?

Devgan: First and most important, I always advise patients to do research prior to choosing a board-certified plastic surgeon and prior to seeking plastic surgery intervention. It is so important to know who is injecting and what they are injecting. Anatomy is everything with an outcome like trapezius Botox, and even though this is a minimally invasive procedure, attention to anatomy remains paramount.

To other clinicians, I recommend educating your patients on the anatomy of the trapezius muscle with it being a larger muscle and requiring a larger amount of neuromodulator to be injected. The effects of this injection will take 2 to 3 weeks to settle in. It is imperative to have a conversation between patient and injector to explain risks, manage expectations and to together meet specific aesthetic and functional goals.

Reference:

• What to know about new TikTok beauty trend ‘Barbie Botox’: From effects to cost. https://www.forbes.com/sites/ariannajohnson/2023/08/18/what-to-know-about-new-tiktok-beauty-trend-barbie-botox-from-effects-to-cost/?sh=211b9968db4f. Published Aug. 18, 2023. Accessed Aug. 28, 2023.