CNN  — 

Isabelle Lux, a 32-year-old content creator from Palm Beach, Florida, said she was terrified while sitting in the chair waiting for her ‘Barbie Botox’ — 40 units of the neurotoxin injected into each trapezius, the muscle holding up her neck. She was looking to slim her shoulders in preparation for her wedding, as well as release some upper back pain. “I was thinking the whole time, ‘If it goes right, this is going to be great and I can’t wait to share it (online). If this goes wrong, I better warn people. So basically I figured no matter what happens, I’m going to tell people.’ And God, I just prayed it went well.”

The procedure was originally devised to aid the release of severely overworked trapezius muscles which could cause migraines and intense neck tension. Now, it’s being administered off-label to cosmetically diminish the size of shoulders, elongating the neck. And it’s gaining traction on social media.

“When Botox is injected into a muscle, it stops the connection to the nerve,” Dr. Parisha Acharya, lead cosmetic doctor at renowned London medical aesthetics clinic Waterhouse Young told CNN in a telephone interview. “Over time it leads to a weakening and paralysis of the muscle. Indirectly, the muscle shrinks away.”

The hashtag ‘Barbie Botox’ currently has over 7 million views on TikTok, where MediSpas and clinics document injecting their clients, adding pastel pink captions and sparkle emojis. Lux’s video detailing her own experience with the treatment has now been viewed more than 250,000 times. She credits herself with coining the phrase. “It came from the idea that you would look more like a Barbie when you get it done, which I don’t think is a bad thing,” she told CNN in a phone interview. “It elongates the neck, slims the shoulders and creates a very delicate physique when it’s done properly.”

From @isabelle.lux_/Instagram
Isabelle Lux has been sharing her results from trapezius Botox on social media.

However, if administered incorrectly, or at the wrong dosage, the Botox could paralyze the muscle completely, said Dr. Acharya. The neurotoxin can also occasionally migrate from the original injection site, weakening the nerve connection of other surrounding muscles.  “And especially if it’s around the neck, that can be quite significant because it can affect your ability to hold your head up properly.”

Lux — who was gifted the $1,200 treatment by an on-demand booking app for aesthetic services — was told to avoid carrying heavy backpacks, strenuous exercise and massages for at least 72 hours. “I was actually quite scared,” she said. “Once (Botox) is in, there’s nothing you can do to reverse it. In the first week I felt so much actual pain, tension and stiffness in my neck, shoulders and upper back. I was really, really worried.” Two months later, Lux said she feels “better than ever” and is already planning a top-up session in the winter.

Still she insists this is not a treatment to be taken lightly. “I think that you need to go to a surgeon or a medical doctor. If you’re not able to get it done at the right place, I would say it’s honestly not worth it.”

The sentiment was echoed by Dr. Acharya, who emphasized her concern at ‘Barbie Botox’ trending on social media, especially as it captures the attention of a much younger audience. “I think a medical procedure should be treated as a medical procedure. And in the UK, (the aesthetics industry) is unregulated. So shockingly anyone can administer botulinum toxin injections. That could be a beautician or hairdresser with no clinical experience, no anatomy knowledge. It really does worry me.”

From @skinsation.la/TikTok
Clients are having their shoulders injected with the neurotoxin to release tension and slim the appearance of the neck.

The global facial injectable market is predicted to more than double in the next decade, reaching $36.8 billion by 2032. According to a 2021 survey by The International Society of Aesthetic Plastic Surgery, there has been a 54.4% increase in minimally invasive procedures like Botox and fillers since 2017.

Lux argues the cosmetic pursuit of doll-like features and thinness in general shouldn’t be condemned. Online, she has been called anti-feminist, insecure and even “a victim of patriarchy,” by one commenter. “The desire to look a certain way has for centuries been seen as silly, a waste of time, waste of money and pointless, especially for women,” she told CNN. “But when a man wants to look a certain way, it’s scientific, it’s cool. I think that we need to stop belittling women for things that they’re interested in, including looking a certain way if they want to. It’s not silly. Like, it’s real.”

For Dr. Acharya, ‘Barbie Botox’ ironically flies in the face of the newly released movie. (“Barbie” is distributed by Warner Bros. Pictures, which is also owned by CNN’s parent company, Warner Bros. Discovery.) “It was very pro-feminism, and (women) were moving away from sexualizing our bodies and thinking of them as just objects,” she said. “I don’t like the fact that this trend is using Barbie to say we should have slim necks. We should embrace ourselves for who we are.”