The alarming rise of 'Barbie botox': young women's quest to get Margot Robbie's look

A viral trend known as "Barbie Botox" is sweeping the US, enticing women as young as their 20s to undergo toxin-based procedures, all in the quest to emulate the looks of Margot Robbie, the lead actor of the recent blockbuster Barbie.

This unsettling phenomenon has raised serious concerns among medical professionals, who fear that its popularity may have dire consequences, not just for those seeking aesthetic enhancements but also for legitimate medical use.

The "Barbie Botox" procedure, alternatively known as "Trap Tox," involves the injection of botulinum toxins, including Botox, into the trapezius muscles of the upper back. Historically, these injections were primarily employed to alleviate migraines and shoulder pain.

However, since the release of the Barbie movie in July, there has been a surge in demand for this procedure for purely cosmetic purposes, with the hashtag #BarbieBotox amassing a staggering 11.2 million views on TikTok.

Scot Glasberg, the president-elect of the Plastic Surgery Foundation, expressed his concern to New York Post, stating, "They're not treating wrinkles or lax skin. They want less girth to their neck, a slimmer, more contoured neck."

What makes this trend particularly concerning is that the approval for such injections for cosmetic use is limited to procedures involving the face, effectively rendering the use of these toxins in the trapezius muscles as "off-label."

The US Food and Drug Administration places the responsibility of determining the "medically appropriateness" of such procedures on health professionals.

While the makers of Botox and similar toxins, Revance and Evolus Inc, acknowledge the surge in interest in "Barbie Botox," they do not anticipate a significant boost in sales.

Of utmost concern to medical experts is the alarming rise in younger women opting for these toxin-based injections. The implications of such a trend could be twofold.

Firstly, there is a potential risk that the effectiveness of these products may diminish over time in individuals with typically robust immune systems.

Shilpi Kheterpal, a dermatologist at the Cleveland Clinic, warned, "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,” New York Post reported.

Secondly, there is a growing apprehension regarding the qualifications of those administering these procedures, particularly at medi-spas where oversight is often minimal.

Melissa Levoska, assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York, told New York Post, "There are no regulations on the type of doctor that can run a medi-spa," which means that even family medicine physicians or OB-GYN physicians can technically open a medi-spa. Increasingly, physician assistants and nurse practitioners are also venturing into administering these injections.

While these toxins are generally safe, improper administration poses a potential risk to nearby muscles, weakening them for months. According to Evolus CEO David Moatazedi, the science isn't yet fully developed to support the clinical profile of such procedures.

Nevertheless, it's known that neurotoxins have been safely used at significantly higher doses for therapeutic purposes than what is typically employed for aesthetic purposes.