Can Scapular Reduction Be Done At The Same Time As Clavicle Shortening?

Q: Dr. Eppley, Here is a photograph of my shoulders for consideration for clavicle shiortening.. I was also wondering if he offered scapula reduction with the clavicle since they can both use the same incision.

A:Thank you for sending your pictures and in preparation for your upcoming consultation I can provide the following comments:

1) I have attached an image of what I predict the operation will be able to achieve from the front view.

2) You have very prominent clavicular show particularly towards the sternum. In such patients hardware prominence is likely which may require secondary hardware removal.

3) Scapular reduction is not done through the same incision as that of clavicle reduction osteotomies. In fact it is done in a completely different intraoperative position. Clavicle reduction is done in the supine position through small incisions just above the clavicle’s in the supraclavicular fossa. Conversely scapular reduction is done in the prone position through back incisions as shown in the attached picture. Unlike the incisions from clavicle reduction such scapular incisions often do not heal well for a scar standpoint due to the very thick back skin. Therefore one has to be particularly motivated to make that scar trade-off.

Dr. Barry Eppley

World-Renowned Plastic Surgeon