Why is my traps getting larger and more tense after traptox?

Question

I always had trouble with tense trapezius muscles. I also wanted a slimmer apperence to the shoulders. I tried botox in the traps 2 times with diffrent providers and the traps are getting larger and more tense than before especially after the first time. Before massage could relax them now they are hard as stone and massage can't relax them anymore. How could this be? Is it the provider ? What can be done. I followed all the instructions

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about the issues you're experiencing with your trapezius muscles after receiving Botox injections. There could be a few reasons why your trapezius muscles are becoming larger and more tense despite undergoing traptox (Botox injections in the trapezius muscles). Here are some considerations and possible explanations:

Possible Explanations:

1. **Compensatory Hypertrophy:**
   - When Botox is injected into a muscle, it temporarily paralyzes it, reducing its ability to contract. This can lead to other nearby muscles compensating for the loss of function, potentially leading to hypertrophy (increase in muscle size) in those areas.

2. **Incorrect Injection Technique:**
   - The effectiveness of Botox can be highly dependent on the injection technique. If the Botox isn’t injected into the correct area of the muscle, it may not provide the intended relaxation effect. This could lead to continued or increased muscle tension.

3. **Inadequate Dosage:**
   - The dosage of Botox may not have been sufficient to achieve the desired effect. If the dose is too low, it may not effectively reduce muscle tension.

4. **Individual Variation:**
   - Some individuals may metabolize Botox differently, leading to variations in how long the effects last or how effective the treatment is. There can be significant individual differences in response to Botox.

5. **Rebound Effect:**
   - In some cases, muscles can become more active after the effects of Botox wear off, potentially leading to a rebound increase in muscle tension.

What Can Be Done:

1. **Consult a Specialist:**
   - Seek a consultation with a specialist who has extensive experience with Botox injections for trapezius muscle issues. They can assess your situation and provide a tailored approach.

2. **Review Injection Technique and Dosage:**
   - Discuss with your provider about the technique and dosage used in your previous treatments. Adjustments might be necessary to achieve the desired effect.

3. **Physical Therapy:**
   - Incorporate physical therapy to help manage muscle tension and improve muscle function. A physical therapist can provide exercises and techniques to help relax and strengthen the muscles in a balanced way.

4. **Alternative Treatments:**
   - Explore other treatment options such as dry needling, acupuncture, or other muscle relaxants that might be more effective for your condition.

5. **Follow-Up and Monitoring:**
   - Regular follow-up appointments to monitor your progress and adjust treatment plans as necessary can help ensure that the treatment is working as intended.

6. **Holistic Approach:**
   - Consider a holistic approach that includes stress management, ergonomic adjustments, and lifestyle changes to reduce overall muscle tension.

Next Steps:

- **Schedule an Evaluation:**
  - Make an appointment with a new provider who specializes in traptox and has a track record of successful outcomes. Bring your previous medical records and treatment history for their review.

- **Detailed Assessment:**
  - Ensure a thorough assessment of your muscle structure and function is done before the next treatment to tailor the Botox injections more precisely.

Addressing your concerns with a specialist can help determine the exact cause and provide a more effective treatment plan moving forward.

David Yew, MD · Answer

This is a good question and the answer is not simple.  Going to 2 different providers who inject differently quantities and locations of the injection make it hard to assess.   I suggest returning to them and asking how many units and where it was placed and why?   The trapezius muscles are broad and it takes an experienced provider to put together a plan on how this works.   In our practice - we palpate for trigger points and relieve those first.   Then we bring back and assess again.   I've never seen the trapezius muscles get bigger and more tense after correct treatment for 3-4 months.   It will eventually wear off and get larger again over time.   Please see attached video

Why is my traps getting larger and more tense after traptox?

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Why is my traps getting larger and more tense after traptox?

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Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.