Q: Dr. Eppley, I am asking to you about a procedure that you probably do not get asked about. So basically there is a plastic surgeon who advertises “shoulder widening” using the patients own bone. The technique is described as making an osteotomy in the bone and inserting a permanent titanium plate to stabilize the bone. I originally thought this was like limb lengthening but he seems to place a bone graft from another body part so it cannot be distraction osteogenesis correct? The technique involves a small incision in the skin overlying the clavicle; creation of an osteotomy (cut in the bone) and insertion of bone grafting material is performed, followed by fixation with a permanent titanium plate. Widening of the shoulders of up to one inch can be achieved.”
Would you ever preform something like this? I am interested in this and have done research on this. I understand even shoulder-shortening is possible. I saw someone ask you a shoulder shortening procedure question a few days ago so I just thought it was worth a shot to get your opinion and see if you would preform, thank you.
A: What you are referring to is a clavicular osteotomy with the placement of a bone graft and plate fixation for stabilization. You are correct that this is not distraction osteogenesis but a straightforward osteotomy and bone grafting. While I have never performed it I can not speak as to its effectiveness. But it would seem that it would provide a shoulder widening effect whose increase would be the separation of the bone ends and the width of the interpositional grafts.
Dr. Barry Eppley