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Clavicle shortening surgery – sometimes called shoulder reduction surgery – is designed to decrease the width of the shoulders. It is frequently done as part of feminization procedures for trans women, but anyone who wants to narrow the width of their shoulders is potentially a good candidate for clavicle shortening. Shoulder reduction surgery can help soften square shoulders or balance the hip-to-shoulder ratio.

During shoulder reduction surgery, a small part of the clavicle bone is removed and the remaining ends are reconnected with either a metal plate or an intramedullary screw. While cosmetic in nature, clavicle shortening surgery may affect the function and mobility of the shoulder if not done properly. Working with a reputable surgeon is vital when undergoing the procedure.

If you are considering clavicle reduction surgery, you likely have a lot of questions. Below, we will provide a brief breakdown of what to expect to help you decide whether or not the procedure is right for you.

Who Is A Good Candidate For Shoulder Reduction Surgery?

Anyone unhappy with the width of their shoulders can potentially opt for shoulder reduction surgery, but it may or may not be the right treatment path for you depending on your desired outcome. Prior to undergoing shoulder reduction surgery, you will have a consultation with a plastic surgeon to go over your goals and expectations. This helps ensure that shoulder reduction is the right choice for you.

As with any other surgery, you will need to have a medical exam and undergo routine blood work. During the exam, you will also discuss your overall lifestyle and current medications. The intent is to ensure that you are healthy enough to successfully undergo surgery.

In some cases, you may be asked to make lifestyle changes – like quitting smoking or losing a certain amount of weight – prior to being cleared for surgery.

The Procedure

There are two primary methods used in clavicle shortening, both of which are done under general anesthesia. In both procedures, your surgeon makes a 1.5-inch incision in the skin above the clavicle on both sides. Then they remove a portion of the bone, which can measure up to 2 centimeters.

What differs between procedures is the fixation method. Your surgeon may either use a metal plate and screws or an intramedullary screw instead of a plate. The main benefit of the second technique is that it calls for a smaller incision, but does require an additional puncture near the end of the clavicle. The intramedullary screw also decreases the potential need for hardware removal since all of the hardware is inside the bone and will never be palpable or visible through the skin. In some cases, the plate and screws that may be used may be palpable or visible through the skin. Any removal of hardware should be done at least one year out from the original surgery.

What Is Recovery Like?

When recovering from clavicle shortening surgery, it is important to work closely with your surgeon and follow their aftercare instructions carefully. Pain should subside within only two to three weeks, and most patients regain a full range of motion within this timeframe. However, your bone takes approximately three months to heal completely. Stressing the bone too quickly can result in injury. A common cause of complications with shoulder reduction comes from patients resuming activities too soon after surgery, inhibiting healing and potentially causing hardware failure.

For two weeks following your surgery, you will need to minimize physical activity as much as possible. The clavicle is a relatively slow bone to completely heal and requires ten weeks before it is sufficiently strong before subjecting it to larger forces such as carrying heavy grocery bags or lifting weights.

Every patient’s recovery path is different, so talk to your surgeon about when you can ease into your normal routine. You will need to refrain from heavy lifting and weight bearing activities for at least ten weeks as your bone heals. You will have regular follow-up appointments with your surgeon to gauge your progress in order to determine when you can resume certain activities.  You will also receive occasional X-rays to follow the healing process of the bone. Once the bone is fully healed, you can return to all of your pre-operative activities without risk.

What Are The Risks?

Every procedure carries some risks. With shoulder reduction surgery especially, it is very important to work with a board-certified plastic surgeon with experience performing clavicle shortening as the procedure requires a lot of technical skill.

Infection may occur initially after your operation, and can be treated successfully with prompt medical intervention. More serious complications like broken screws and non-union of the two ends of the clavicle (lack of boney healing) may occur in the weeks following surgery and may require follow-up treatment.

Scarring is usually minimal with shoulder reduction surgery, but some patients are genetically prone to thicker scarring. If you are concerned about scarring, talk to your surgeon about treatment options. There are many non-invasive forms of therapy that can successfully reduce scarring.

Shoulder Reduction Surgery: The Bottom Line

Shoulder reduction surgery can shorten and reshape the shoulders to create a more proportional and a potentially more feminine frame. While recovery can be quite lengthy, most patients end up happy with the final result. If you do decide to undergo shoulder reduction surgery, make sure you work with an experienced surgeon and follow all aftercare instructions closely to avoid complications.

Ready to get started? Leif Rogers is an Ivy League-educated, board-certified plastic surgeon and a standing member of the American Society of Plastic Surgeons. If you’re considering shoulder reduction surgery, get in touch with his team to schedule a consultation. 

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