Trap Tok or Barbie Botox

Have you heard about the trending Trap Tox or Barbie Botox. The procedure involves injecting a neuromodulator (e.g. Botox or Dysport) into the trapezius muscle to help slim the shoulders and neck. The treatment will help to relax the trapezius muscle and should not impact normal movement of the arm, shoulder or neck. As the injections take effect, generally over 4-6 weeks (though some may see results sooner and some may take 2+ months for full effect), you will see a slimmer looking neckline. Depending on the size and strength of the muscle it may take 30-50 units per side and results generally last 4-6 months.

In addition to slimming the appearance of the neck, this treatment can also help to reduce muscle tension (which may be exacerbated as we slump our shoulders forward looking at our phones or working on computers). It may also help relieve tension headaches and migraines.

With any treatment it is important to be assessed by an expert to determine if the procedure is right for you.

Top Treatments for Boosting Collagen

As a cosmetic dermatologist I wanted to share some treatments to stimulate collagen that I think are worth the money. I realize in office procedures can be $$$ and the most affordable things you can do are sun protection to preserve existing collagen and retinoids (as well as some other topical skincare) to stimulate collagen. However, as I’ve posted before there are limits to what skincare can do. 

🔹 IPL paired with Clear and Brilliant laser - these two treatments work synergistically and I love to use them together to help even out skin tone, treat pigmentation, and improve pore size, fine lines and texture.  

🔹 EmFace is a newer treatment that uses high frequency electrical stimulation to tone the muscle and provide lift to the brows, cheek and jawline area combined with radiofrequency to improve skin quality. It is one of my new favorite treatments.

🔹 Ultherapy is a non-invasive treatment that uses ultrasound to strengthen existing collagen and stimulate new collagen production to help tighten the skin on the face, neck and other areas.  

🔹 Microneedling can help with fine lines and texture. It is safe on many different skin types and you can take it safely right up under the eye to help with some of those under eye concerns 

🔹Last but not least is skincare. Not exactly a “treatment” but it plays a role in overall treatment plan. The ABCs of skincare are: Vitamin A (retinoid), Sunblock (SPF), and Vitamin C (antioxidant). All have data that use can protect your skin’s collagen and/or stimulate new collagen.

For those wondering about oral collagen supplements, for me the jury is still out and though there may be benefits it is not where I would invest if considering any of the options above.

Five Top Cosmetic Injectable Treatments

As a cosmetic dermatologist I specialize in non-invasive treatments for the skin. While there are a lot of great devices we use (and I’ll share some in a future post) a lot of my time is spent injecting. Here are my five favorite injectable treatments:

💉 Neuromodulators such as Botox and Dysport are of course a gold standard cosmetic treatment that can help both prevent and treat dynamic wrinkles such as frown lines and crow's feet. Botox can also be used for many other treatments including a subtle “brow lift,” reducing bunching of skin under the eyes (“jelly roll”), tightening of the platysma bands on the neck (Nefertitii lift), and “lip flip.”  The use of cosmetic Botox was pioneered here in Vancouver by Jean and Alastair Carruthers, who I had the pleasure of training with and working with.

💉 One of my personal favorite treatments is injections of microdroplets of hyaluronic acid (“skin boosters”) to help improve skin quality and hydration. These come under the brand names SkinBoosters or Skinvive / Volite. It is a great treatment on its own or in combination with other treatments.

💉Hyaluronic acid fillers can be used strategically to help with loss of volume over time. They can be used to enhance a certain facial feature or help with shape or proportion. Effectively done fillers can subtly enhance and look natural. 

💉 Biostimulators like Sculptra or hyperdilute Radiesse are injectables that help stimulate your body's own collagen and improve skin quality and can help to lift and tighten. 

💉 Platelet-Rich-Plasma (PRP) can be injected in the scalp to help with hair growth, or can be injected to help under eye concerns like dark circles or in other areas to stimulate collagen. It can also be paired with microneedling to help with skin texture, fine lines and acne scarring. 

Botox Basics

Some basic information for anyone considering cosmetic botox or just curious to learn more. First, Botox is a brand name for botulinum toxin A. The name is often used to describe a whole class of neuromodulators / neurotoxins but there are multiple products on the market that work in a similar manner. I will use “botox” generically here to include other products like Dysport, etc.

With botox, the effect occurs at a specific location where it is injected in the muscle. Here the botulinum toxin attaches to nerve endings. Once attached it inhibits the release of the neurotransmitter responsible for triggering muscle contractions. It reduces the strength of the muscle, thereby minimizing the appearance of wrinkles as muscles remain relaxed. The effects will generally last for 3-6 months but varies based on area injected, amount injected and muscle strength.

One of the most common uses for botox is to treat lines in the upper third of the face. These lines are formed due to repetitive muscle movement. One location is the glabella, where botox is used to treat the “11s” (the lines made when you frown). Botox can also be used to treat horizontal forehead lines, “crow’s feet” and "bunny lines." We also use it to provide an eyebrow lift, to help with dimpling of the chin, and to treat masseters for TMJ pain and also to slim the face. There is a long list of areas that can be treated, both on and off label.

It's important to understand that botox works to treat dynamic wrinkles, not static wrinkles. Dynamic wrinkles only appear when you make facial expressions, for example when you furrow your brow, frown, or smile, so you don't see them when your face is still. For deeply etched in static lines, soft tissue fillers may need to be considered as well.