What is TrapTox?
TrapTox — popularly known as Barbie Botox — is the injection of botulinum toxin (Botox, Dysport, or Xeomin) into the upper trapezius muscle. When the upper trapezius is relaxed, the bulkiness at the top of the shoulder softens, the shoulder line descends and slopes more gently, and the neck appears longer, more slender, and more defined. The silhouette shift is immediate and the effect is cumulative with repeat treatments as the muscle gradually atrophies.
The treatment has two distinct patient populations: those seeking the aesthetic effect — the elongated neck and softer shoulder line — and those seeking relief from chronic trapezius tension, neck pain, and tension headaches. Most patients find they get both simultaneously, which has contributed significantly to its growth in popularity.
At Plump Medical Spa in Newport Beach, TrapTox is $1,200 and is performed personally by Dr. Mortazavi on both sides in a single session. No downtime.
The two reasons patients book TrapTox
Quick facts at a glance
How the treatment works
The upper trapezius is a large, fan-shaped muscle that runs from the base of the skull across the shoulders and down the upper back. It is responsible for shrugging the shoulders, stabilizing the neck, and — in many patients — holding a significant amount of chronic tension.
Botulinum toxin is injected into multiple points along the upper trapezius on each side, using a series of small injections distributed across the muscle belly. The toxin blocks the nerve signals that cause the muscle to contract at full strength. Over 5–10 days, the muscle relaxes. The shoulder line drops and softens, the neck appears longer, and the characteristic trapezius bulge diminishes. Tension held in the muscle releases simultaneously.
The procedure takes approximately 15–20 minutes for both sides. No topical numbing is typically needed, though it is available for patients with lower pain tolerance. There is no downtime — patients return to normal activity immediately, with the single exception of avoiding vigorous exercise for 24 hours post-treatment.
The upper trapezius has significant anatomical variation in size, thickness, and depth between patients — and lies in close proximity to the spinal accessory nerve, the brachial plexus, and the posterior cervical musculature. Incorrect injection depth or placement can produce weakness in unexpected muscle groups or spread to adjacent nerves. Physician-performed TrapTox with anatomy-based injection points is meaningfully safer than standardized protocols performed by non-physician injectors. At Plump, every TrapTox injection is mapped to your specific anatomy at consultation.
Who is a good candidate
What TrapTox does not do
Managing expectations is an important part of any consultation for this treatment. TrapTox relaxes and gradually reduces the upper trapezius. It does not reduce fat in the neck or shoulder area, it does not lift the skin, and it does not change bone structure. Patients with broad shoulders due to skeletal structure rather than muscle development will see a more modest change than patients whose width comes primarily from muscle.
The visual effect is also more pronounced on patients who start with a more prominent trapezius. Patients with naturally sloped shoulders and minimal trapezius development may see less dramatic transformation — though the tension relief benefit applies equally regardless of starting anatomy.
TrapTox and exercise: Patients who lift heavy weights — particularly overhead pressing, shrugging, and deadlifting — may notice some reduction in trapezius endurance and strength at higher doses. This is not harmful but should be discussed at consultation. Most recreational athletes experience no meaningful functional limitation at standard dosing. Competitive athletes or those whose work requires trapezius strength should discuss this specifically before proceeding.