What Are The Long Term Risks Of Shoulder Reduction Surgery?

Q: Dr. Eppley, I recently read an article that was published by Realself on shoulder surgery, they stated some possible short and long term complications that I don’t remember hearing about during our consultation. It has sparked some questions for me.

In the consultation I was told that the main risks associated with shoulder reduction surgeries is failure of the fixation hardware and non-union of the bones and that if there were to be a complication it would most likely happen in the first couple months. I don’t believe I was made aware of any potential long term complications.

Here are the concerns listed in the article:\

“ Immediate risks of clavicle surgery can include sensory nerve damage or a collapsed lung, while “long-term risks include hardware irritation and, most important, the permanent shift of the shoulder girdle,” The muscles where the scapula and clavicle connect to the arm could become weakened and easily fatigued over time, ultimately impeding the shoulder’s ability to move effectively. “

I’ve also heard some say that the new shorter length of the bone straining to work with the scapula will cause early arthritis down the line. I’ve heard others say that the scapula will move to accommodate the new length of the clavicle. I’m not sure where this information is from though. I of course understand that there is limited research and knowledge on the subject but can you speak at all to arthritis or chronic muscle fatigue being valid concerns? And how would this procedure collapse a lung? 

In the Realself article it also mentions that one should follow this procedure with physical therapy. Is that part of your recovery process? If so, does the PT have to be done with a licensed professional or can it be done from home? If it’s not part of your prescribed recovery do you still recommend it? 

Apologies for the long list of questions but I appreciate your time and attention. Thanks,

A: In answer to your questions the first comment I would make is be very cautious of doctors or others making comments on a procedure that they have never performed. The only opinions that should matter in any surgical endeavor should be from those who have done (surgeons) or have undergone (patients) the exact procedure you are considering having done. Outside of that perspective all such comments are theoretical and lack any proven medical relevance and thus their value should be taken as such.

To date there is no evidence of any adverse long term effects from shoulder reduction surgery which includes the stated muscle fatigue or arthritis. However until the procedure has been performed on hundreds of patients with very long term followup (10 to 20 years) no one can say for certain if any such adverse effects exist….but it seems unlikely based on patients who have been through the surgery in the past five years.

The only relevant long term risk ghat I have seen is whether the patient will want the fixation hardware removed due to either show through the skin or irritation.

Other than at home arm range of motion after 6 weeks postop I do not prescribe any specific physical therapy.

Dr. Barry Eppley

World-Renowned Plastic Surgeon