Objectives: To describe the clinical rationale and outcomes of botulinum toxin injections in the trapezius muscle for aesthetic contouring of the neck and shoulders, and for the management of tension-type headaches and migraines.
Introduction: Botulinum toxin has long been established as a therapeutic agent in both aesthetic and neurological applications. Recently, its use in the trapezius muscle has gained attention for dual benefits: improving upper body aesthetics by reducing muscle bulk and tension, and alleviating symptoms of migraines and cervical tension headaches. This treatment offers a non-surgical alternative to refine neck-shoulder contours while addressing chronic pain in select patients.
Materials / method: Botulinum toxin type A was injected bilaterally into specific points of the upper trapezius muscle, using anatomical landmarks to optimize both functional and cosmetic outcomes. Patient selection included individuals seeking shoulder-line refinement, posture improvement, and/or migraine relief. Doses ranged from 80 to 160 units per side, depending on muscle bulk and clinical indications. Treatments were performed in outpatient settings, with follow-up at regular intervals to assess efficacy and patient satisfaction.
Results: Patients experienced visible softening of the shoulder line and elongation of the neck silhouette within 2–4 weeks post-treatment. Many reported significant reductions in muscle tension and frequency or intensity of migraine episodes. Aesthetic improvements typically lasted 3–5 months, with functional benefits showing variable duration. Adverse events were rare and self-limiting, including transient weakness or local discomfort.
Conclusion: Trapezius botulinum toxin injections offer a valuable, minimally invasive option for patients seeking both aesthetic refinement and migraine relief. This dual-purpose approach aligns with the growing trend of combining functional and cosmetic outcomes in aesthetic medicine. Proper technique and patient selection are key to maximizing results while minimizing risks.
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