Q: Dr. Eppley, I have extremely narrow clavicles which have caused years of insecurity. I’m very interested in the deltoid implant surgery that you offer. I think I read that the maximum amount that you can add to each shoulder in width is 1.5cm. Is this figure correct and does it apply to both the method of silicone implant as well as the fat grafting technique?
A: Deltoid augmentation (aka deltoid muscle augmentation) can be done by either fat injections or actual deltoid implants. If you have adequate fat, fat injections would be preferred since they are the most natural and are scarless to perform. While not all the fat will survive, fat injections would always be the first choice. If one does not have enough fat than only an implant can be used. This is placed through an incision in the skin crease at the back of the axilla (armpit) and the implant is placed in a subfascial location over the central segment of the deltoid muscle.
Both deltoid augmentation approaches take about the same amount of time in surgery and both have about the same recovery. Neither deltoid augmentation technique will create a full 1.5 cm per side, close but not always.
Dr. Barry Eppley