Trap botox, also called Barbie botox or “traptox”, is botulinum toxin injected into the upper part of the trapezius muscle, which runs between the neck and the shoulders. The name “Barbie botox” comes from social media, where it’s linked to a long, slim neck.

The trapezius is a large muscle that helps move the head and shoulders. Intense exercise, long hours at a desk, stress and sitting with raised shoulders can make its upper part look bulky. The neck can then look shorter and the shoulder line heavier.

Botox reduces the muscle’s overactivity, and over time the muscle also becomes a little smaller. The transition from neck to shoulder looks softer and the neck looks longer. The active ingredient is the same as in regular botox; what differs is the area and how the dose is planned.

Trap botox is most often considered for:

• A prominent trapezius: a bulky shoulder line and a neck that looks short.
• Neck and shoulder tension: in people whose muscle is constantly tight, it may help ease the feeling of tension.
• A more elegant neck and shoulder line: for people who prefer a non-surgical, temporary change.

The look of the neck doesn’t depend on the trapezius alone; skin, posture and neck bands play a part too. For vertical neck bands and the jawline, the Nefertiti lift and neck botox can be planned alongside it. Which areas are treated is decided at your consultation.

It is not done during pregnancy or breastfeeding, with neuromuscular conditions, or with an active infection in the area. If your job or sport relies heavily on your shoulder muscles, discuss this with your doctor beforehand.

The appointment starts with an examination. The doctor looks at your neck and shoulder line from the front and back, and identifies where the muscle is most prominent and how the two sides differ.

1. The skin is cleansed and the injection points are marked.
2. Botox is injected into the upper trapezius at several points on each side with fine needles.
3. The dose is planned according to the muscle’s thickness and the difference between the sides.
4. The area is checked after treatment.

Treatment is quick, and you can return to your day straight away. Because the trapezius is a large muscle, the dose differs from facial treatments, so it should be planned by a doctor who knows muscle anatomy well.

After treatment, it’s recommended that you:

• Don’t lie down or massage the area for the first 4 hours.
• Avoid intense exercise, alcohol, saunas and steam rooms for 24 hours.
• Avoid carrying heavy bags or loads for the first few days.

The most common effects are mild tenderness, redness and small bruises at the injection points. Some people notice mild shoulder fatigue or weakness when lifting heavy things in the first weeks. These effects are temporary; contact your doctor if you notice anything unexpected. For general aftercare, read what not to do after botox.

Trap botox is temporary. The muscle usually starts to relax within the first 1–2 weeks. The slimmer look from the muscle getting smaller develops gradually and becomes clearer over a few weeks.

Results vary from person to person but usually last 4–6 months. Muscle strength, daily use and metabolism can affect this. When the effect wears off, the muscle returns to how it was before, and the next treatment is planned at a follow-up based on the muscle.

If the lower face looks wide because of muscle, or you grind your teeth, masseter botox works on a similar principle and can be considered separately. The low-dose technique preferred for natural results in the face is explained on our Hollywood Botox page.