How Can I Fix My Shoulder Asymmetry?

Q: Dr. Eppley, am seeking advice regarding a longstanding concern about the appearance of my shoulders and clavicles. I have attached photographs that clearly show the issue.

My left clavicle appears noticeably shorter than my right, and my left shoulder seems to sit further underneath the clavicle rather than extending outward in the same way as my right side. As a result, there is much less separation between my left shoulder and clavicle, making it appear as though I have little or no shoulder on that side. In contrast, my right shoulder has a much more typical appearance with greater width and definition.

To the best of my knowledge, this is not the result of any injury or trauma. I have no known medical conditions and have noticed this asymmetry for as long as I can remember, dating back to my early teenage years. My father’s shoulders, while naturally slim, are symmetrical and proportionate, so I have been unable to identify any obvious familial explanation.

This issue has had a significant impact on my confidence and mental wellbeing. I find myself avoiding T-shirts and beach holidays, and I often go to considerable lengths to make my shoulders appear more balanced under clothing. At 32 years old, this remains a source of distress, and although my fiancée is supportive, she does not fully understand the extent of my concern.

I would be very grateful for your assessment of whether there could be an underlying anatomical cause and whether there are any investigations or treatment options that might improve the asymmetry or its appearance.

Thank you for your time and advice.

A: Thank you for your inquiry and sending your shoulder pictures in which the shoulder asymmetry is apparent. The definitive assessment requires a 3D CT chest scan to fully see the bony anatomy and any comments I make are preliminary to that visual analysis.

This appears to be a congenital shoulder asymmetry where the entire shoulder unit is situated lower (not shorter). It does not appear to be an issue with clavicle bone length on the affected side.

But again until I see a 3D CT scan and make measurement of the clavicle length and see its angulation compared to the other side I can not be sure.

There are some potential corrective procedures such as clavicle bone lengthenng and deltoid and trapezius muscle implants. But it is yet unclear what, if any these would be beneficial.

Dr Barry Eppley

Plastic Surgeon