Q: Dr. Eppley, In addition to my previous email, I’ve become intrigued by a recent post you put up on IG regarding clavicle reduction. I’m interested in doing somewhat of an “upper body feminization” if you will. I’m transgender (MTF) and am interested in learning more about whether there would be any significant benefits to such a process. I was thinking of a combination of clavicle reduction, scapula reduction and rib removal.
I understand the rib removal process since it’s relatively straight forward. However, I’m interested to know about the other two procedures and so I have the following questions;
1- in terms of diameter, how much reduction can generally be achieved with clavicle reduction?
2- If scapula reduction can be performed, how big of a scar would result and where would the incisions be placed?
3- Can all three surgeries be accomplished at the same time?
Aside to the aforementioned questions, I’d also like to get a quote from your office regarding the above procedures.
I have attached the photos originally requested and an attempt of clavicle photos, please let me know if further photos are needed.
A: I think it is important to review the anatomy of the scapula which is the best way to determine the implications of its reduction besides the scar. By your pictures the most prominent part of the scapula is its inferior angle. This bony portion of the scapula is the origin of the terms major muscle which has a role in arm movement. Between the scar and the loss of teres major muscle attachment I would be very cautious about considering this type of back contouring procedure. Its is not a question of whether it can be done but whether its tradeoffs are worthwhile. I would be more enthusiastic about it if the inferior angle was shaved rather than completely removed, thus keeping some of the muscle attachments.
In answer to your other questions:
1) For the clavicular reduction procedure, I would refer to one of my websites, www.exploreplasticsurgery.com, where you can search under Shoulder Width Reduction. There you will find detailed answers to your questions as to how the procedure is done with clear pictures of it.
2) I think that putting together all three body contouring procedures together, even if scapular reduction is advised, is too much from a recovery standpoint,. Even any two of them would be difficult.
Dr. Barry Eppley