What Is TrapTox (& What Does Barbie Have to Do with This Buzzy Aesthetic Trend?)

Those who are often on TikTok might already be familiar with the term “TrapTox.” And for the rest of us, no, it’s not another subgenre of hip hop, as this editor briefly wondered.

TrapTox is a portmanteau that refers to the injection of Botox into the trapezius muscle. Sometimes referred to as “Barbie Botox” because of the slimming effects it’s purported to have on your neck, the treatment gained popularity earlier this year, as did everything else related to Barbie in 2023. But as often is the case with aesthetic trends on TikTok, there are many details that are left out of the discussion, which we’ll get into with the help of our experts.

• Dr. Jennifer Levine is a double-board certified plastic surgeon and triple Ivy League trained with 20 years of experience in the field. Dr. Levine shares her expertise frequently in various publications, and as Professor of Facial Plastic and Reconstructive Surgery at New York University School of Medicine.
• Dr. Ron Espinoza, a board-certified cosmetic and plastic surgeon with offices in Miami and NYC. Dr. Espinoza received his medical degree from The New York College of Osteopathic Medicine in Brookville, NY. After this, he was an intern at Nassau University Hospital. Following his internship, he completed his General Surgery residency at St. Barnabas Trauma Level 1 Hospital in the Bronx. He continued his training there, receiving his fellowship degree in Plastic Reconstructive Surgery. Dr. Espinoza is affiliated with the American Osteopathic Plastic Surgeons Association.

“TrapTox is a neuromodulator (like Botox, Xeomin or Dysport) that’s injected into the most prominent part of the trapezius muscle, between the neck and shoulders,” says Dr. Levine. “For patients who have a lot of tension in the area or want it to appear less bulky, these injections can temporarily ease some of that stiffness and make the area less prominent.”

As Dr. Espinoza further explains, “Botox and other neuromodulators work by inhibiting the contraction of the muscle, thereby preventing the wrinkles of facial expression. When it’s injected into the trapezius muscle or traps, it will weaken it, and with subsequent treatments, it can lead to atrophy, slimming down of the muscle, which can give the appearance of a longer neck.”

Aesthetic reasons aside, some people get TrapTox for relief from headaches that are caused by stiff neck muscles. “Since Botox relaxes these muscles by weakening them, this can decrease headache frequency. I have had patients coming in asking for this treatment to see if it will help their migraines,” says Dr. Espinoza.

“TrapTox isn’t a good idea for people with neuromuscular disorders,” cautions Dr. Levine, who also recommends telling your doctor if you have any autoimmune conditions that could affect your muscles. On that note, while generally considered safe, “TrapTox injections should be performed by a skilled provider who understands the anatomy of the area. Sometimes the muscular tension in the area may be caused by muscles other than the trapezius, so a thoughtful exam is necessary beforehand,” she adds.

“TrapTox is indicated for patients with pain, discomfort or spasms in the area,” says Dr. Levine. “Yes, there are some cosmetic benefits you could get from it, but the trapezius is a muscle that has an important function, so weakening it is not a good long-term option.”

In other words, if you have medical reasons for getting TrapTox, it might be worth discussing with your doctor. If it’s purely for cosmetic reasons, you may want to reconsider.

As Dr. Espinoza shares, “Risks are relatively low, but patients should be aware that injecting neuromodulators to these muscles could weaken their shoulder and arm movements, which is something they may not like and/or have to get used to.”

One final consideration is time and cost. “TrapTox is not a one-time treatment, so it will require patience on the part of the patient to see results,” says Dr. Espinoza. “Also, the effects usually last three to four months, before the muscle becomes fully active again, at which point you’ll have to go back for more injections.”