Woman Says 'Barbie Botox' Helped Her Sleep Quality, But What Are the Risks?

With the Barbie movie on track to become the highest-grossing film of the year, last week joining the $1 billion club in global box office sales, it has inspired many trends—cosmetic procedures included.

"Trap tox" refers to the trend of injecting botulinum toxin A (also referred to as the brand name Botox) in the trapezius muscle. Dubbed "Barbie Botox," it's increasing in popularity in the wake of Barbie to give the appearance of a slimmer neck and more svelte silhouette like the iconic doll. One woman even says that it has improved her quality of sleep.

On TikTok, #barbiebotox has had over 1 million views in the past week, 9 million overall since the first of over 300 videos using the hashtag was posted. One video on TikTok posted by the account @livin.lavina.loca shows a woman explaining her decision to get "Barbie Botox."

"So I succumbed to 'trap tox' and I got, like, the Barbie Botox in your traps," the woman says in the video. "But the biggest side effect that I feel like is not talked about enough is how relaxed it makes you.

"I've released some tension that I've been holding on to for years. I haven't slept this well in like, I don't know how long. I didn't realize how much tension I held in my shoulders until this, and it's only day two. I'm really excited to see how this kicks in."

While botulinum toxin is a licensed substance by the U.S. Food and Drug Administration, it has not approved its use for reducing the size of the shoulders, also known as "off label." The FDA deems a substance licensed after it has "determined the benefits of using the drug for a particular use outweigh the potential risks."

"When you are prescribed a drug for its approved use," says the FDA, "you can be sure:

• "That FDA has conducted a careful evaluation of its benefits and risks for that use.
• "The decision to use the drug is supported by strong scientific data.
• "There is approved drug labeling for healthcare providers on how to use the drug safely and effectively for that use."

Newsweek spoke to Dr. Emmaline Ashley, a medically qualified cosmetic physician with a background in aesthetics and dermatology about the trend.

"This isn't a brand new treatment and has been carried out with varying degrees of popularity in different parts of the world," she told Newsweek. "It is particularly popular in Asian countries and it's starting to be seen in clinics across the U.K. It is gaining recognition at the moment due to its presence on social media and the recent explosion of the Barbie movie."

Botulinum toxin is a muscle relaxant that works by blocking the action of a chemical called acetylcholine, which makes the muscle tighten. The original use of botulinum toxin began in the 1970s when scientists started using it to treat strabismus, also called crossed eyes. While testing the effect of the toxin on this condition, scientists noticed that wrinkles along the brow ridge had been reduced.

"Botulinum toxin has been used for medical purposes since the 1970s, and its cosmetic use is a more recent thing," Ashley said. "It has been used to treat muscle spasms, eye disorders like strabismus, excessive sweating, migraines, and bladder problems. It has a strong record of being safe in medical hands for problems.

"Ideally, this is a treatment that should be done under careful direction of a medical professional who has assessed there is a clinical need for the treatment," she said, "It can sometimes be part of a migraine treatment as well. However, I think it is really important to be very cautious of chasing trends and of weakening muscles that are important for function for purely cosmetic purposes.

"This can be a dangerous area to inject if you are not a qualified professional, and you need to have experience and a deep understanding of anatomy to administer this safely and ethically," Ashley said. "Personally, it is not a treatment I would offer."

Beauty trends inspired by Barbie have been cause for concern in other areas over the years as well, prompting the "Get Real Barbie" campaign created by the South Shore Eating Disorders Collaborative (SSEDC) to raise awareness during National Eating Disorders Awareness Week in February, sponsored by the National Eating Disorders Association (NEDA).

Two Barbie dolls are sold every second throughout the world, according to SSEDC, which expresses concerns about the impact this cultural icon could have on young women's body image.

"If Barbie were an actual woman, she would be 5'9" tall, have a 39" bust, an 18" waist, 33" hips and a size 3 shoe," SSEDC said. "9 Barbie calls this a 'full figure' and likes her weight at 110 lbs. 9 At 5'9" tall and weighing 110 lbs, Barbie would have a BMI of 16.24 and fit the weight criteria for anorexia. She likely would not menstruate."

With these dimensions, she would also most likely have to walk on all fours due to her proportions.