Everything You Need To Know About Clavicle Surgery
From breast and pectoral implants to liposuction and even ‘trompe l’oeil’ contouring, the chest is often an area of focus in aesthetic medicine. More recently, clavicle (a.k.a. collarbone) surgery is growing in popularity among patients seeking to change the length and prominence of the bone, enhance their décolleté, and improve the overall proportion of the body.
Clavicle surgery can be performed to either shorten or lengthen the bone. Often, patients going through gender reassignment surgery or looking for a more masculine appearance will have their collarbone lengthened, while those seeking a more feminine appearance will have the bone shortened to improve the shoulder-to-waist balance. Here, The AEDITION breaks down the intricacies of the procedures.
Clavicle Shortening Surgery
When performed for cosmetic reasons, clavicle shortening surgery can result in an overall narrowing of the shoulder area. While the technique is often used to treat patients who are undergoing additional feminization procedures (it is a solution for softening square shoulders and balancing the shoulder-to-hip ratio), some opt to undergo the procedure purely because they are unhappy with their natural shoulder width.
“The shoulders roll forward slightly, giving a slightly rounded appearance, which my patients do not object to,” says Leif Rogers, MD, a Beverly Hills-based board certified plastic and reconstructive surgeon, of the procedure’s results. “Many of these patients have very prominent, visible collarbones, which can be made less visible if desired by adjusting the angle of the bone. The more rounded appearance tends to look a bit more feminine.”
Surgeons can achieve up to just over an inch of shortening with the procedure, which can have a tremendous impact on the overall balance and measurements of the body.
How a Clavicle Shortening Procedure Works
There are two primary methods that can be used to achieve the desired results — both of which are carried out under general anesthesia. As Dr. Rogers explains, shortening of the collarbone is performed by creating a 1.5-inch incision in the skin above the clavicle on each side. A portion of bone is removed measuring up to two centimeters (or about 10 percent of the total length of the collarbone). In the first fixation method, the two ends are brought together and fixed using a metal plate and screws. “The scar that results has been very thin in all patients to date,” he says.
In the second technique, an intramedullary screw is used instead of a plate. “It can be done through a smaller incision, but it requires an additional puncture near the end of the clavicle,” Dr. Rogers shares. “The advantage is the hardware is never palpable through the skin.”
Clavicle Lengthening Surgery
When it comes to lengthening collarbones, the results are essentially the exact opposite of shortening. “The procedure results in the shoulders becoming more square — or less rounded — and the chest appears broader,” Dr. Rogers explains. “The collarbones can be made to be more prominent, too.”
The clavicles can be lengthened by up to an inch (give or take), and the surgery results in a wider shoulder area. People often opt for the procedure as part of overall masculinization efforts (think: pectoral implants or fat grafting), but the procedure is also carried out on patients who are simply unhappy with the area’s natural appearance.
How a Clavicle Lengthening Procedure Works
Like clavicle shortening, surgery to lengthen the clavicle is performed under general anesthesia and results in minimal scarring. During the procedure, the bone is cut in an oblique (read: diagonal) manner, and the two ends slide over one another to create about 15 to 18 centimeters of increased length. A plate and screws are used to fixate the bone, as the intramedullary screw method does not work for lengthening, Dr. Rogers notes.
Recovering from Clavicle Surgery
Due in part to the orthopedic nature of the surgery, recovering from clavicle surgery is a lengthy process. There is, however, relatively little pain and full range of motion returns almost immediately after surgery. “It takes about one to three weeks before the soreness resolves and about three months total for the bone to attain full strength,” Dr. Rogers says.
While a complete return to exercise and function (including sports and weightlifting) takes about three months, normal activity — excluding weight-bearing and heavy lifting — is possible just a few days after the procedure. It is important to not get lulled into a false sense of security. “Patients have a tendency to return to full activity too soon because the area is virtually always pain-free after three weeks,” he warns. “The bone is not healed at this point and issues can arise if the bone is stressed too early. Patients must allow the full three months to heal before returning to full activity.”
Scarring from the procedure is also minimal. The incisions are placed just above the clavicle on either side, in the hollow between the collarbone and the neck. “The skin in that area tends to form very nice scars,” Dr. Rogers explains. “However, some patients may tend to form thicker scars genetically. If that were to happen, there are therapies to improve the appearance of scars.”
It’s also important to remember that the plate used to stabilize the bone can be felt under the skin. “To date, no patients have complained of the plates,” he says. “But if a desire to remove the plates exists, they can be taken out after about a year.”