A cosmetic treatment known as Barbietox uses large amounts of Botox to give patients a more slender, Barbie-like neck. Photo / Getty Images
Just when you thought the pastel hype from the Barbie movie had reached its rosy peak, another trend inspired by the doll that took over the world has cropped up. This time in the cosmetic treatment space: Barbietox.
It’s one of several trending treatments an increasing number of Kiwis are enquiring about or undergoing, buoyed by influencer promotion and the changing faces of celebrities.
New Zealand cosmetic treatment doctor and co-president of the New Zealand Society of Cosmetic Medicine, Sarah Hart, says in her line of work, things go viral on social media in a way that they don’t for other areas of medicine.
Along with cosmetic nurse Emma Lindley, she describes the most unusual cosmetic trends piquing the interest of New Zealanders and offers a word of warning for those seeking out these off-label procedures.
Hart explains that Barbietox has become the term to describe a procedure that creates an elongated neck resembling the slender nape of a Barbie doll.
She says while it has previously been known as swan neck and a popular treatment in Asia, Kim Kardashian talked about it on social media as Barbietox and a rabid interest followed, including among Kiwis.
“The Barbie movie plus Kim Kardashian talking about it made everyone talk about this procedure … The trapezius muscle on top of your shoulders, you see a sort of triangular-shaped chunk of muscle. If you inject that muscle with a large amount of Botox it will shrink that bulk muscle away at the side of the bottom of the neck. It can end up making the neck look longer.”
It’s an off-label treatment, meaning it’s not allowed to be advertised in New Zealand but it can be carried out under informed consent by a registered practitioner.
“You’re ending up using half of a vial of Botox and looking to actually shrink the muscle right down by really strongly relaxing [it],” says Hart, noting half a vial is a lot when you consider a frown line requires approximately one-fifth of a vial.
“I have certainly done the treatment but that has been more for my patients that I treat for muscle spasms. I’ve got a group of patients that I’ve treated for, say, Bell’s palsy or facial twitches or treating tense muscles in the face instead. So putting Botox into the trapezius muscle can help relax it when it’s overdeveloped and tense and causing headaches. And because it’s part of the injection sites for migraine treatment.”
Cosmetic treatment nurse Emma Lindley has also seen an increase in enquiries for Barbietox, which she notes can be effective for new mothers with built-up tension. By relaxing the area, it can encourage engaged core muscles, she says.
A growing trend popularised by the likes of Chrissy Teigen, Bella Hadid and Liam Payne is buccal (pronounced buckle) fat removal.
Hart explains that “Buccal is the area of your cheek under your cheekbone. The little bit that can puff out and make your face look a little bit square.
“There’s a celebrity trend to remove this little fat pad that’s called the buccal fat pad and you just do a little incision inside the mouth and pop it out. It makes your cheekbones look a lot more defined and makes your face look a lot slimmer.”
But Hart, who is currently treating a patient for the fallout from the procedure, says people need to be aware of the effect over time.
“There can be a lot of downsides later on. Your face could look exceptionally gaunt and it can effectively age your face … It’s a very small number of people that it would be suitable for.”
Hart has taken on a client who had buccal fat removal “done on a whim overseas in her early 20s”.
She came to Hart at 25, “having lost the weight she had temporarily gained and saying, “Oh my goodness, my face looks older”.
While Hart has treated her with filler to replace that buccal fat, she tells the Herald: “It’s never quite the same. You can’t put it right back where the buccal fat was with filler and it never quite functions in the same way.”
But, despite the potentially dire outcomes, “People are starting to ask about it like it’s a mainstream thing because of it being on social media.”
Another trend Lindley has noticed, particularly among women in their 20s and early 30s, and one that she believes is spurred by Instagram, is jawline filler.
“The younger generation is quite interested in filler jawline treatment. They want quite an acute, 90-degree jawline which is actually a massive masculine quality but that’s what they’re seeing on Instagram,” says Lindley who runs Injectables by Emma in Auckland.
“It’s not a good thing because if you look at the patient front on, if the practitioner isn’t assessing properly, it can actually square the face which masculinises it away from a feminine face. The angle for a female jawline shouldn’t be 90 degrees.”
A popular treatment that requires careful consideration and has been around for some time is the lip flip, an off-label treatment using Botox or surgery to make the top lip look fuller.
Hart says, “People see these trends overseas and they go, ‘Oh my god, look! I want the lip flip Botox’ and in reality, that’s a treatment that’s quite short lasting. It’s a six to eight-week treatment that has a subtle effect and doesn’t suit the facial structure of a lot of people.”
She explains that for a small number of people, “lip filler is not appropriate and if they have a very long philtrum, the space between the bottom of the nose and the top of the lip, the surgical lip flip might be the only thing that’s going to give them the result that they’re hoping for”.
However, Hart and Lindley note it’s a procedure that can affect the function of your mouth.
“How you enunciate, how you talk, how you purse, how you drink from a straw ... It’s not as straightforward as what it looks like,” says Lindley. “It’s actually having the conversation about the functions of these muscles.”
Hart says when she tells patients of its short-term effect and how it “affects the movement of your mouth and your ability to press your lips, people are like, ‘oh, I don’t want that’. So, we talk about other ways of making the top lip look bigger and usually a small amount of dermal filler placed very carefully is a more long-lasting effect.”
Hart has previously spoken to the Herald about the lack of knowledge around filler and its potential permanence.
She points to findings by an Australian radiologist who also does injectables. Using MRIs they discovered that filler can still be present seven to eight years after being injected.
“It’s not just sort of a playground for your face,” says Hart. “And that you go, ‘Oh we’ll just get it and it’s worn off in six months, it doesn’t matter.’ It can last longer and if you don’t like it, not all practitioners are happy to dissolve out a treatment done by someone else.
“So these treatments are dissolvable but it’s not like waving a magic wand or erasing something out. You have to undergo another medical procedure and it could be hard to find a practitioner that does that.”
Face value: Lindley advises that when you meet the person you’re entrusting with your treatment, make sure that they’re on the same page as you about what you’re trying to achieve.
“If somebody goes into a consult with a practitioner and they don’t like the way that they look in terms of the practitioner looks over-treated, the likelihood of them making you look over-treated is high.”
Consent: Understanding the consenting process is also crucial, says Lindley.
“For example, I do Botox on the day of consult but I don’t do filler on the day of consult because the risks and the procedure itself is more involved.
“The Medical Council also suggest that the patient should go away and have a think about the procedure because it does last longer.”
Training: Hart says it’s important to ask about the training your potential practitioner has had, how many procedures they’ve done and the relationship they have with the doctor providing their standing orders.
Photos: As a standard part of your procedure, you should also expect photos - because they can be the only way to identify issues with a treatment.
“If [a practitioner] doesn’t get their patients back and take photos and examine those photos both at rest and on movement, you won’t see those mistakes.
“So often people aren’t aware of them themselves. You don’t see yourself making movements.”
Ongoing care: The practitioner should also provide you with after-hours contact details should any issues arise from your treatment. And they should be able to ensure that they can manage any potential complications.
Rebecca Haszard is a senior lifestyle and entertainment writer, co-host of the Herald’s parenting podcast One Day You’ll Thank Me and a former digital and magazine editor, including Girlfriend magazine.
New York Times: These charismatic cooks are a counter to harder-edge chefs.