Am I A Good Candidate for Custom Deltoid Implants?

Q: Dr. Eppley, I am 42 years old and suffered a high impact shoulder dislocation when I was 18 years old resulting in axillary nerve damage and subsequent atrophy of my deltoid muscles. I have now lived with this deformity for more than half of my life but it has always bothered me and I am very self conscious of it. In searching the internet for possible solutions, I stumbled across your website and was excited to see there may be an answer. I would be interested to see if I would be a candidate for reconstructive surgery/implants. I’m an Oregon resident so I am not sure if there might be anyone you could recommend in my area but if you have experience with this and can help me, I can certainly consider coming to your location. I have attached a few photos as well. I look forward to hearing back from you about what how you might be able to help me.

A: Thank your for your inquiry and sending your pictures. You certainly have the classic major deltoid muscle atrophy from an axillary nerve injury. For which implant augmentation would be the only effective recontouring method. The only issue is getting the best size of the implant to do so. One method is to do a moulage technique in the office which is impractical given your geographic location. Another method is to get a 3D MRI and try and match the muscle size based on the opposite side. The third method is to use an existing deltoid muscle implant design from previous patients that have had the exact problem as you.

Dr. Barry Eppley

World-Renowned Plastic Surgeon