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My favorite spot in my weekly hot yoga class is directly facing a full-length mirror. Enjoying an unobstructed view of my body allows me to make minuscule adjustments. Recently, however, I’ve been zeroing in on my shoulders, where my trapezius muscle looks bulkier and more sloped than ever. Yoga poses like Dolphin can help loosen the trap muscle—but maybe not enough for me, since I spent much of the pandemic hunched over my laptop. Body Botox, the latest aesthetic trend, might be able to help.
“Body Botox is the next frontier,” says Lara Devgan, MD, a plastic surgeon in New York. She explains that the neurotoxin botulinum toxin type A (which extends to other brands like Dysport and Xeomin) can help streamline and release hyperactive muscles and address minute muscle pain in some off-label uses. Trapezius Botox, colloquially called “traptox” or “Barbie Botox” (referring to the doll’s angular shoulder line), is one of the most common forms of this neurotoxin-fueled, muscle-slimming treatment.
With traptox, a small amount of neurotoxin is injected between the neck and the shoulders, according to New York plastic surgeon Melissa Doft, MD. She says that traptox doesn’t just help slim the trapezius muscle—it also relaxes it, which can help you stand more upright. The result is a more elongated, swanlike neck (like Barbie’s), or one that’s closer to a beauty standard that Koreans have dubbed “90-degree shoulders.” (K-pop fans have praised their idols, like Blackpink’s Jennie, for having shoulders that form a sharp right angle to the neck.)
Botox does something that’s difficult to address through exercise: acting as a quick fix for slimming overworked muscles, which Devgan likens to putting on a “chemical cast.” “The idea is that over the duration of Botox, we’re not causing the same neural signals to fire and bulk the muscle, so you get a controlled slimming,” she says. It can also be used to slim gastrocnemius muscles in the calves, smooth platysmal bands to help alleviate “tech neck,” and relieve overactive masseters in the jaw. New York plastic surgeon Ramtin Kassir, MD, uses it to relieve deep muscle knots found via ultrasound. Neurotoxins are also known for their ability to curb excessive sweating, or hyperhidrosis, when injected into the skin rather than into a muscle.
Ellen Marmur, MD, a New York dermatologist, does caution that Botox should never be injected in any essential muscles, like abs or glutes. It’s important to see someone who’s not just knowledgeable about neurotoxins, but also adept in anatomy, like a dermatologist or plastic surgeon. They can tell you if you’re a candidate for body Botox and ensure correct placement if you move forward. David Kim, MD, a New York dermatologist, notes that though there aren’t many complications associated with body Botox—it’s best to start with a small dose and work your way up.
Large, powerful muscles shouldn’t be frowned upon—building strength is crucial to overall health, flexibility, and posture. It’s what allows me to practice yoga in the first place. Think of body Botox not as a tool to shrink healthy muscles, but as a way to help address imbalances and anything else causing pain or poor posture. It’s akin to really good tailoring, Devgan says. A few small injections in targeted areas can help streamline the anatomy. “You see this with fashion, the line of clothing, and the cut, and the reason everyone’s obsessed with Khaite now,” she says. “Those little [details] in line and form and function make a big difference.”
A version of this story appears in the May 2024 issue of ELLE.