Everything You Need to Know About ‘Barbie Botox’

Have you heard? The girlies on TikTok are going crazy for partial neck paralysis. Okay, maybe that’s a slight exaggeration, but they are getting neurotoxins like Botox, Xeomin and Daxxify shot into their neck and shoulder areas. Deemed “Barbie Botox” (because it’s meant to give you the delicate bearing of a doll, which is basically the exact opposite message Greta Gerwig meant to send) or “TrapTox,” influencers like Isabelle Lux and others have helped popularize the procedure. Botox and other neurotoxins, which are primarily used to help treat lines and wrinkles in the face, have long been employed in off-label ways like this, for treating ailments such as headaches, jaw pain and excessive sweating. Below, everything you need to know about the newest TikTok craze.

What is Barbie Botox?

“Barbie Botox is really Botox to the trapezius muscles,” facial plastic surgeon Dr. Levine told ELLE.com. “The trapezius muscle is a large fan-shaped muscle that goes along the back of the neck and then along the back of the shoulder. It’s a place where we hold a lot of tension, and because we’re using that muscle instead of other muscles, it can get quite bulky. This can lead to tension or pain in the neck and shoulder and upper back.” If you’re overusing your trapezius muscle, it can also make your shoulders and neck look bulky, which some patients don’t like.

What exactly does Barbie Botox do?

If patients are experiencing extreme pain in the trapezius, or they don’t like the bulky shape of their shoulders and are looking for a more slender neck, they can get Botox in one area of the trapezius that will help to relax the muscle, Dr. Levine said. Within a month or so, patients will feel less tension in that part of their neck and shoulders, and the area may start to appear more slender, elongating the neck.

How does it work?

“You’re going to inject it in the place that’s holding the most tension,” Dr. Levine said. “So if you were looking at the area of your neck to your shoulder, in certain people with a more prominent trapezius there’s almost like an area of elevation, and that’s where you would start the injection.” From there, she said, you’re going to apply Botox at the peak of the tension of the muscle in a box-like shape, going back towards the back, in about four rows of five injections. You obviously don’t want to apply Botox to the whole muscle—the idea is simply to apply enough to the peak of where your tension is to relax it enough that the tension releases and your neck is elongated.

Can you use any neurotoxin, or does it have to be Botox?

According to Dr. Levine, you can use any neurotoxins for the procedure, including Daxxify, Xeomin and others.

How many units do you need?

You’ll use about 30 to 50 units of Botox for each side, so in total you’re looking at about 60-100 units. Depending on where you’re getting the procedure, that can be about $1,000.

How long does it last?

It depends what kind of neurotoxin you choose. Botox typically lasts between three and four months, while Daxxify has been proven in clinical trials to last between 6 to 9 months.

What are the risks associated with Barbie Botox?

As always, ensure you are going to a licensed medical professional, like a dermatologist, physician, or nurse practitioner when interested in injections like Botox, Xeomin, or Daxxify. These injections are only FDA approved for the face and injections in any other area are deemed “off-label” and at the judgement of the medical professional. If injected in incorrectly, it can weaken the muscles around the trapezius.

How popular is Barbie Botox, really?

“Initially it was uncommon—maybe once a month,” Dr. Levine said. Now that it’s gone viral on TikTok, she’s seeing patients for the procedure about once a week. “It’s still not a huge thing,” Dr. Levine said. “Usually if they’re thinking about that many units they have a lot of other places that are a bigger priority.” But, she points out, it’s very popular in countries like Korea, where they’ve been doing Botox to the trapezius for years.

Jessica Roy is the former Digital Director of ELLE.com. Prior to that, she worked as the News Editor of The Cut. She likes baking, running, and Instagrams of your dog.