Tell someone you’re getting Botox, and, regardless of their familiarity with beauty terminology, they’ll have a solid idea of what you’re talking about. Tell someone you’re getting “traptox,” however, and, depending on how deep into the #DermTok hole they’ve traversed, they may understand or they may think you’re catching a Pokémon.
The term traptox is a portmanteau combining trapezius, the triangular muscles that cover the shoulders and back of the neck, and Botox, the injectable that has become the genericized trademark that refers to the entire neuromodulator category. (While many doctors use Botox for traptox treatments, other neuromodulators like Dysport and Xeomin can also be used.) Neuromodulators are famously used to relax forehead lines, but shoulders aren’t exactly as prone to expression-induced wrinkles the way the brow area is… so why are dermatologists and plastic surgeons injecting these formulas into the trapezius muscles?
If you’re a fan of procedure-demonstrating TikToks and Reels, you probably already know the answer to that, considering traptox — which has also come to be known as Barbie Botox — became a prolific social-media content topic in 2023. But just in case you’re not (and even if you are) we spoke to dermatologists to give everyone a clearer idea of why someone might want to inject Botox into their traps.
Meet the experts
- Shereene Idriss, MD, is a board-certified dermatologist based in New York City.
- Jeffrey Fromowitz, MD, is a board-certified dermatologist based in Boca Raton, Florida.
What is traptox?
“Traptox is Botox injected into the trapezius muscle of your upper back, shoulder, and neck area to relieve the tension and help with any occasional headaches," says New York City board-certified dermatologist Shereene Idriss, MD. But aside from aiding with physical discomfort, there’s a cosmetic perk that’s getting a lot of attention, too: “It also helps to elongate the look of your neck."
That elongation is more or less an optical illusion, as nothing about the neck itself is really changing — what you’re seeing is what the neuromodulator does to the muscles around the neck. “[Traptox] can give the neck a slimmer and longer appearance by decreasing the muscle bulk surrounding it,” says Jeffrey Fromowitz, MD, a Boca Raton-based board-certified dermatologist. “It addresses shoulder thickness that can occur with overdevelopment of the trapezius muscle” from working out.
How much does traptox cost?
What you’ll pay for traptox is dependent on a wide number of variables: the injector you go to, which neuromodulator brand they use, and the region you live in, Dr. Fromowitz says. The cost also relies, perhaps more than anything else, on how many units are injected.
“Each treatment should be tailored to the patient and their specific needs,” Dr. Idriss tells Allure. This means taking medical history, pain tolerance, anatomy, age, and other factors into consideration. She adds that, when name-brand Botox is used, in general, most people start with about 40 units on each side — that’s about one forehead’s worth of Botox per shoulder.
Dr. Fromowitz says that your doctor may end up administering up to 100 units of Botox depending on their assessment of your needs. So what impact could that ultimately have on your wallet? On average, he says you can expect to pay between $1,000 and $2,000 per treatment.
Are there any side effects to traptox?
Dr. Fromowitz and Dr. Idriss say traptox is a safe treatment. However, like virtually every cosmetic procedure, there are some risks to be aware of.
“Side effects are more likely to occur if [mistakenly] injected outside of the traps, like the sternocleidomastoid (SCM) muscle, which is involved in turning the head side to side,” says Dr. Fromowitz. “In these cases, you might have weakness in this muscle.” Shoulder weakness may also occur, he says, from over-injection of the trap, which is why your doctor may take a conservative approach in determining how many units you need to get neck-lengthening results without adverse effects.
Patients with pre-existing medical conditions should make their injector aware of them. “If you’re prone to muscle weakness and have any autoimmune conditions that affect your musculature, I would approach cautiously,” Dr. Idriss says, adding that you may experience weakness when lifting heavy objects.
It’s worth noting that traptox is an off-label treatment, meaning it’s not an FDA-approved usage for neuromodulators. That’s why it’s particularly important to go to a board-certified dermatologist or plastic surgeon when seeking out the treatment for cosmetic purposes.
How long does it take to see traptox results?
If you’re used to getting Botox to relax wrinkles, you’re probably accustomed to seeing its effects kick in within a couple of weeks. But with traptox, you may need more patience. “Neuromodulators take anywhere from one to two weeks to kick in,” Dr. Idriss says, “but because the muscle is larger in size, it may require up to four weeks to visibly see a difference.” That said, if you’re also seeking out headache and tension alleviation, she adds that the majority of people “will see results in terms of pain relief first as you can physically feel the difference versus analyzing the aesthetics.”
As for the duration of the results, Dr. Fromowitz says it varies from patient to patient, but you can expect them to last about the same amount of time as brow Botox: three to four months.
That is, of course, if you even get the results you’re seeking. Some patients may not get the noticeable or quick outcome they’re hoping for from traptox, and this could be due to a variety of factors.
The promise of a longer-looking neck may sound appealing to those with kyphosis, a forward curvature of the upper spine — casually known as a hunchback — but unfortunately, traptox is unlikely to make a difference in its appearance. “Botox injections are not considered a standard or effective treatment for correcting spinal curvature or managing kyphosis,” Dr. Idriss explains. “Treatment for kyphosis typically involves a combination of physical therapy, exercises, and bracing. In severe cases or when other treatments fail, surgical intervention may be considered to correct the spinal curvature and stabilize the spine.”
Ironically, although Dr. Fromowitz says traptox addresses the look of thickness, it’s thickness that may hinder more apparent results. “If there is thick skin or adipose tissue [AKA body fat] overlying the muscle group, the impact of injections might be more limited visually,” he says.
My personal traptox experience
Unfortunately, I’m one of the traptox patients whose results were “more limited visually” — not to mention I haven’t experienced relief from tension in the area. When I didn’t see a difference three weeks after an initial, conservative treatment, I returned to my dermatologist for additional units. I was hopeful to experience a noticeable lengthening effect, but after two months, I still don’t see or feel a difference. It’s unclear why — as far as I know, I don’t have thick skin or an especially excessive amount of adipose tissue in the area — but needless to say, it’s disappointing.
Does that mean everyone who seeks out traptox will end up wasting their money? Absolutely not. Results like the example Dr. Idriss shared with Allure (above) show that there really can be a noticeable dip in the trapezius muscles after treatment, creating that desired elongated look.
Read more about in-office aesthetic treatments:
- Is Emface a Needle-Free Alternative to Botox and Filler? I Tried It
- Does Daxxify Work Better Than Botox? I Tried The New Neurotoxin.
- How I Really Feel About My Lip Lift
Watch a dermatologist's entire routine:
