The recent release of the Barbie movie has sparked a viral trend among young women to get toxin-based procedures, commonly known as “Barbie Botox”, to mimic the looks of the film’s lead actress Margot Robbie. This trend has raised concerns among doctors, who are worried that the increased demand may lead to resistance among younger women and hinder medical use in the future.
The procedure, also known as “Trap Tox”, typically involves injecting botulinum toxins, such as Botox, into the trapezius muscles of the upper back to treat migraines and shoulder pain. However, since the movie’s release, doctors have seen a surge in demand for the procedure as a cosmetic treatment to slim the neck. The hashtag BarbieBotox has gained significant traction on social media platform TikTok, with over 11.2 million views.
Despite the trend, doctors are cautious about the use of off-label injections, which are not approved for cosmetic purposes by the US Food and Drug Administration. “They’re not treating wrinkles or lax skin. They want less girth to their neck, a slimmer, more contoured neck,” said Scot Glasberg, president-elect of the Plastic Surgery Foundation, who practices in New York.
The use of toxin-based injections for cosmetic purposes is typically limited to procedures involving the face, making the use of the injection in the trapezius “off-label”. Doctors are concerned about the rise in use among younger women, who may have stronger immune systems and are more likely to experience complications from the procedure.
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Furthermore, the increased demand has led to a rise in the number of underqualified staff administering the procedure, raising the risk of complications. “There are no regulations on the type of doctor that can run a medispa,” said Melissa Levoska, assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York. This has led to concerns about the administration of the procedure by individuals who may not be properly qualified.
In addition, the use of toxin-based injections among younger women may lead to resistance to the products over time. “If they’re doing high amounts of Botox very frequently… they may lose its effect over time, not just with Botox, but with the other products in the market too, because they all have some similar molecule,” said Shilpi Kheterpal, a dermatologist at Cleveland Clinic.
The manufacturers of the toxins, including Revance and Evolus, do not see the trend significantly boosting sales. Botox maker AbbVie declined to comment. Historically, people above 40 years would opt for toxin-based injections, and the market is estimated to be worth over $3 billion in annual sales in the US.
Despite the concerns, doctors are emphasizing the importance of proper administration and the potential risks associated with the procedure. “The science isn’t quite there yet, in order to support the clinical profile of it,” said Evolus chief executive David Moatazedi. “However, we do know neurotoxins have been used at doses significantly higher for therapeutic purposes than the level of being used for aesthetic purposes and we know the products are safe.”
