What Can Be Done For A Shoulder Soft Tissue Atrophy After Multiple Failed Fat Injection Treatments?

Q: Dr. Eppley, Im writing to you because i find your work amazing! I want to do several aesthetics procedures with you. But i have a big big problem, who makes me sad everyday….. 

I would like to find a definitive solution for my shoulder. I have a skin congenital atrophy yon my shoulder. (lack of fat?? or I don’t know I was born like this). It looks like a crater. I was looking for doing PMMA injections on it as I have already had multiple fat injections and they didnt work. 

It would be my biggest dream to find a permanent solution, without thinking about doing several injections, or taking care or my weight for not loosing graft, or be able to use my shoulder. 

Is that possible for you, to customized an implant for me? To fill the hole? Like this it would be definitive! I found a doctor in China but I have seen your work and it would be amazing if you can help me. 

Thank you in advance doctor!!! 

Have a very nice day!! 

A: Thank you for your inquiry and sending your pictures. That shoulder appears to have a congenital subcutaneous atrophy/dermal thinning. While injection fat grafting would be the obvious solution, having failed that numerous times it is time to try something else. While the implantation of ‘something’ would be the correct alternative, and one could use an implant (ultrasoft thin sheet of perforated silicone), I would think first about an allogeneic dermal graft. (e.g., Alloderm) This very pliable sheet of 2mm dermis would act like an implant from a fill standpoint but it would be incorporated into your tissues which I think is better long-term in such a high motion area.

Dr. Barry Eppley

Indianapolis, Indiana