‘Barbie Botox’ trend has people breaking the bank to make necks longer. Is it worth it?

Barbie has re-entered the cultural zeitgeist − and perhaps despite the film's best efforts − not without inspiring yet another unnatural beauty standard.

"Barbie Botox" has exploded in popularity over the past year on TikTok, where videos tagged #barbiebotox have garnered nearly 4 million views. The cosmetic treatment involves injecting botulinum toxin, or a similar muscle-paralyzing neurotoxin, into the trapezius muscles, or traps, with the intent of flattening the shoulders to give the appearance of a longer neck.

Proponents say the treatment helps them achieve a silhouette more closely akin to the plastic Mattel doll invented in the 1950s.

Dermatologists say trapezius Botox, the original name for Barbie Botox, has historically been used in fields like neurology, pain management and orthopedics to treat a host of medical concerns.

"This is something that has been done for a couple decades now, but it got recently popularized for aesthetic purposes definitely in the last year," says Dr. Danilo Del Campo, a Chicago-based dermatologist who says he saw several more patients inquire about the treatment last month following the release of the "Barbie" movie (never mind that a major theme of the film is finding beauty within yourself, no matter what you look like).

TikTok and other social media apps also appear to have fueled the trend, says New York-based dermatologist Dr. Anthony Rossi, who has provided trapezius botox for over a decade.

"People are asking about it, because they see it on social media," he says. "It's really wild how much social media really penetrates all over."

'We're trying to replicate something that's very artificial'

But does Barbie Botox even work in achieving the desire outcome? Dermatologists say the treatment is generally safe and can make a difference in one's appearance, though usually only a subtle one.

By keeping the traps paralyzed, Barbie Botox aims to make these muscles relax and atrophy over time, causing the shoulders to appear flatter and the neck longer, Dr. Del Campo says.

"Like anyone who goes to a gym knows, the more that you work out a muscle, the bigger a muscle gets," he says. "So if you're preventing a muscle from doing contractions, you're preventing it from getting larger, and you're going to make it get smaller, especially over a longer period."

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Though it's impossible to actually elongate the neck, Barbie Botox, by relaxing the shoulders, can make the neck appear longer by contrast, and many patients who seek the treatment strive to achieve as close to a 90-degree angle between their neck and shoulder lines as possible, like a Barbie's.

It's an aesthetic inherently unnatural to the human form, Dr. Del Campo adds. After all, Barbie doesn't even have traps.

"Barbie dolls don't have any trapezius muscles if you look at them," Dr. Del Campo says. "We're trying to replicate something that's very artificial."

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Is 'Barbie Botox' worth it?

Prices for Barbie Botox can range from a couple hundred to a couple thousand dollars, depending on location and quality of treatment, which typically involves six to 10 injections per shoulder.

Plus, multiple rounds of Barbie Botox over several months are often necessary in order to see and maintain a difference in appearance. The treatment usually takes about two weeks to notice effects, and one round of treatment can last about three to four months or more, depending on the neurotoxin used.

"Myself, I'm not speaking for or against it, but it's one that does cost a lot of money for very subtle changes," Dr. Del Campo says. "Some people might find a value in it, but, in general, I try to approach people to just try other avenues."

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Still, there are non-cosmetic benefits of Barbie Botox could be worth the high price point for some patients, Dr. Rossi says. These include alleviating neck and shoulder tension, muscles spasms, migraines and trapezius hypertrophy, or enlargement of the traps.

"Unless you're really having pain, I don't think it's necessarily the most bang for your buck," he says.

Dr. Rossi encourages people to pause and reflect before seeking cosmetic treatments based on social media trends.

"We live in this age of social media where things really can take off," he says. "While social media can really increase awareness and increase information, there has to be some sort of responsibility about it too."

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