Botulinum Toxin Procedure

A Botulinum Toxin Procedure That Isn’t for Your Face

“Barbie Botox” and “traptox” are the latest buzzwords gaining popularity on social media with content creators lauding the procedure and sharing their results. The clinical term, Trapezius Botox, highlights the focus of the procedure targeting the base of your neck, extending across your shoulders and down to the middle of the back.

The procedure isn’t new and has been used to treat severely overworked trapezius muscles which could cause migraines and back tension – particularly used to treat ‘tech neck’ as a result of our prolonged sedentary periods in front of laptop and computer screens as well as the angle at which mean spend hours a day on their mobile devices.

Aesthetically, many patients have started getting the procedure to achieve the illusion of smaller shoulders that elongate the neck – mimicking the look of Barbie – with celebrities like Kim Kardashian sharing that they have botulinum toxin injected into her shoulders.

“When botulinum toxin is injected into the trapezius muscles it prevents them from becoming overworked by stopping the connection to the nerve, says Dr. Alek Nikolic, aesthetic medicine specialist and owner of Aesthetic Facial Enhancement. “The botulinum toxin relaxes the muscles which causes the shoulder area to slim down and results in the elongation of the neck.”

Botulinum Toxin Procedure

“What many don’t know is that the trapezius muscle is near vital respiratory and central nerve control centers and is one of the few places where botulinum toxin can have fatal results. These negative effects are often not spoken about,” adds Dr. Nikolic.

“I would advise anyone considering aesthetic treatments to do their research, consult with qualified medical doctors, and consider all aspects of the procedure including their desired results before proceeding.”

Dr. Nikolic cautions against trying out medical procedures purely based on social media trends, instead investigating thoroughly the need for them. When it comes to ‘traptox’, the reality is the procedure weakens the muscles that are important for daily bodily function.

This procedure can also be costly as the trapezius muscles are large and would require a sizeable dose of botulinum toxin – approximately 100 units. The results of this procedure are typically seen four weeks after the injections and last for about three to four months depending on how many units are used and the person’s metabolism.

Patients who received botulinum toxin injections for trapezoid muscle treatments have reported side effects such as serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia. In these cases, the adverse reactions were not necessarily related to the distant spread of toxin but may have resulted from the administration to the site of the injection and adjacent structures. In several of the cases, patients had pre-existing dysphagia (difficulty in swallowing) or other significant disabilities.

In a nutshell, potential side effects include:

  • Hypersensitivity reactions
  • Increased risk of clinically significant effects with pre-existing neuromuscular disorders
  • Difficulty in swallowing and breathing difficulties
  • Bronchitis and upper respiratory tract infections in patients treated for spasticity

To learn more about botulinum toxin and how it can benefit your specific concerns, please contact Dr. Alek Nikolic or check out the website at