Is Everybody Getting ‘TrapTox’ Without Me?

What is TrapTox?

I did not initially set out to receive TrapTox; rather, it fell onto my shoulders. TrapTox, or trapezius botox, explains celebrity cosmetic dermatologist Dr. Paul Jarrod Frank, is the use of one of several neuromodulators off-label, like Botox Cosmetics, Xeomin, Dysport, Daxxify, or Jeuveau to flatten the trapezius muscle, which connects the shoulder to the neck, creating the appearance of a thinner and more prominent neck. In other words, TrapTox is meant to feminize the look of your shoulders, hence where the Barbie aspect to this comes in: by decreasing the aesthetic prominence of the muscle.

Aesthetics aside, TrapTox can also alleviate pain and tension in the trapezius muscle, which tends to get overused. “[It is] a muscle that is getting activated and hypertrophied from working at a desk, poor posture that rounds out the shoulders, looking at our phones, etc. Often, my patients want it done to achieve both goals. It is a similar concept to masseter Botox (i.e., facial slimming and TMJ relief),” explains Dr. Shelia Farhang, board-certified dermatologist and cosmetic surgeon and founder of Avant Dermatology & Aesthetics.

Though TrapTox is the aesthetic treatment of the moment, its functional usage has existed for several decades. “[It] was [used] for a condition called Torticollis—a crick in the neck—where there is a type of spasticity of the trapezius and neck muscles that can lead to difficulty in moving the neck,” explains Dr. Frank.

My Experience

My TrapTox injections happened by accident—allow me to explain. I visited Dr. Farhang in New York City for a quick touch-up around my crow's feet. I have been dedicated to Botox since I started getting injectables, but Dr. Farhang suggested I try Xeomin since it was what she had on hand then. Truthfully, I had always been curious about that neurotoxin due to its high-profile celebrity endorsements so I was game to try. As she began injecting and we got to talking, our conversation turned to TrapTox, and she asked me if I was interested in trying it. I didn’t hesitate. “YES,” I said. Luckily, prep for injecting TrapTox, as with prep for any neurotoxin injection, is the same: to avoid Ibuprofen or aspirin to prevent bruising, which I had none of before my injections. All I needed to avoid in the hours after the injections, she explained, was a neck massage (which I had not planned on getting) and carrying a heavy bag on my shoulder to prevent product movement. I happened to have been carrying a large bag to my appointment that day, but after my treatment, I hilariously carried it down the street in my hands to avoid any complications.

I exposed my shoulders and lowered my bra straps to prepare myself for the injections. Dr. Farhang told me she would also use the Xeomin for my TrapTox (or Trap Xeomin—not as catchy). Though the brand name Botox has been popularized for use with the treatment, Dr. Frank explains that no neuromodulators are considered better than the other for the treatment; any of them can be used to achieve your desired result. Xeomin it was.

Before she began, Dr. Farhang mapped out the injection points on my shoulders with a white pencil, with about three to seven injection points on each side. She planned out the injection points by asking me to move my arms up and out in front of me. She planned to inject 20 units on each side. She explained that she typically injects 20-40 units in each trap. “I tend to be conservative with all tox [because], one—we can always add more, and two —these are muscles you actually need, and we don’t want to overdo and paralyze it,” she says.

It’s important to note that depending on the neurotoxin used, “...[T]here is a wide variability in how much someone needs,” explains Dr. Frank. Normally, he adds, people could use between 50 and 200 units, with the average dose being 50 to 100 units per side. “If someone does yoga, pilates, is very athletic, or does activities that depend on neck strength, I always start at a lower dose and slowly go up higher,” says Dr. Frank.

As she began injecting, she utilized a small vibrating tool, the one you’ve probably seen on an injector’s Instagram reels that looks like an elongated “T.” It creates a buzzing sensation, helping to distract your brain from any pain or discomfort you feel during injections. “Due to the muscle being large and deep and close to some nerves, some injections can be a little more sensitive and tender,” says Dr. Farhang. Though I tend to have a high pain tolerance with injectables, I was mostly comfortable, but a few pricks made me wince, as they must have been closer to some nerve endings. It was then that the vibrating tool came in handy. The injections were pretty quick, and within a few short minutes, I was done. I felt very slight soreness but nothing significant other than knowing I had just had my muscles injected.

My Results

At about a week post-injection, I noticed a slight difference in my shoulders, and my neck looked slightly elongated. As expected, the time frame to see results is similar to facial injections. “You want to give it seven to ten days to kick in completely,” says Dr. Frank. There is no post-care for Trap Tox other than the aforementioned avoidance of neck massages (in case you had plans afterward) and carrying anything heavy on your shoulders to prevent moving the product around.

As for how long it lasts, Dr. Frank says, “With neuromodulators, there's variability in how long it lasts. Four to six months is the average, but this is dose-dependent. There is a cumulative effect; whereas you may only notice some cosmetic difference after the first treatment, as subsequent treatments progress, you will notice a greater slimming because the muscle does atrophy a bit.”

Dr. Farhang adds that the good thing about the muscle atrophying is that even as the neurotoxin wears off after a few months, it will take a while for the muscle to get strong and bulky again. If you want to protect your investment, try avoiding exercises or weight lifting that may build up those muscles again.

What Are the Risks of TrapTox?

As always, there are risks with any injectable, treatment, or procedure. Though, with TrapTox, because the effects last so many months, it’s important to be extra cautious, especially when choosing the right injector. “The main side effect, as with any use of a neuromodulator, is over-relaxation of muscles,” says Dr. Frank. Dr. Howard Sobel, clinical attending dermatologic surgeon at Lenox Hill Hospital, warns that getting TrapTox injections can “...[P]ossibly leave people with weakness in the neck, causing them not to lift their head.” He adds that injecting too much or the wrong muscles can lead to difficulty moving your head back and forth due to decreased muscle support in the neck. Despite these potential risks, Dr. Frank assures that since the trapezius muscles are very large, it would take a significant amount of product injected into the muscle for any of these issues to occur.

What Are the Costs?

Expect TrapTox, depending upon the provider, location, and size of your trap muscle, to run you anywhere from $500 to $3,000. “People with greater prominence and greater discomfort or spasm will need more,” says Dr. Frank.

My Takeaway

As mentioned, though I did notice that my shoulders were slightly slenderized and my neck a little more elongated, it was by no means a drastic change when I looked into the mirror. I did not get enough units to truly fall in love with the treatment, but even so, this TikTok trend is incredibly over-hyped. With any treatment, I always weigh the cost versus the reward, and for this beauty writer, TrapTox did not feel totally worth it to me. That being said, would I give it a second chance and inject more next time around? Absolutely.

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