News Shoulder Widening 2020 State-Of-The-Art Review and Comparison (DO vs. Bone Graft vs. Sliding Clavicle Osteotomy vs. Alloplastic)

Chintuck22

Chintuck22

Hi hiiii hi ♥
Joined
May 16, 2019
Posts
5,597
Reputation
8,460
Time online
86d 5h 47m
You see my brocel, even if i'm being nice to others, there will be always some imbeciles who will want to take you down. Show no love for them, keep them to the fucking curb !
 
aut0phobic

aut0phobic

no bro
Joined
May 27, 2019
Posts
4,339
Reputation
6,403
Time online
58d 12h 21m
@RealSurgerymax

forgot to ask, what's the projected timeline for recovery & can you get to near 100%? A lot of debate surrounding this on the forum.
 
lasthope

lasthope

Knowledgable
Joined
Nov 11, 2018
Posts
699
Reputation
330
Time online
32d 19h 55m
I don’t charge for these, but right now I’m running behind on DMs. I had to take a break because of how many and the quality of attention is going down. If you dm me now I will get to it in about a week
I waiting since over a month for my pn :feelswhy:
 
RealSurgerymax

RealSurgerymax

From .net
Joined
Jul 24, 2020
Posts
546
Reputation
890
Time online
13d 20h 14m
@RealSurgerymax

forgot to ask, what's the projected timeline for recovery & can you get to near 100%? A lot of debate surrounding this on the forum.

80% Back to normal in 6 weeks
90% in 3 month
95% in 6 months
99% in 1 year

Everyone’s will be a little different. For example some people may feel a sharp pain for up to a year after whenever they put a large amount of force on it (like benching)

Bodybuilders will have to take a minimum 6 month break from heavy lifts. That’s another downside to this surgery as everyone here should be working out in the ideal situation.
 
lasthope

lasthope

Knowledgable
Joined
Nov 11, 2018
Posts
699
Reputation
330
Time online
32d 19h 55m
One reason they have been taking so long is I have been in the middle of sorting out a new aesthetic theory I want to apply to everyone in my DMs now
Do you know how long it does approximately take? Wanted to consult docs for surgeries but need to know what I need lol
 
to_stop_da_cope

to_stop_da_cope

THE NEW BIGBICEPS
Joined
Oct 3, 2020
Posts
3,400
Reputation
3,605
Time online
19d 13h 8m
One reason they have been taking so long is I have been in the middle of sorting out a new aesthetic theory I want to apply to everyone in my DMs now
you also help with facial surgeries?
 
RealSurgerymax

RealSurgerymax

From .net
Joined
Jul 24, 2020
Posts
546
Reputation
890
Time online
13d 20h 14m
Do you know how long it does approximately take? Wanted to consult docs for surgeries but need to know what I need lol
This week I will be catching up on DMs after my break which lasted about 2 weeks. Between here, Lookism and the snapchat line I have abotu 75 to get through so probably some time next week.

Edit:
@lasthope I saw it is you, you are on my list for this week probably tomorrow

you also help with facial surgeries?
The face is the chief seat of beauty and my main focus.

However I am still knowledgable in Liposuction, Calf/Bicep/Deltoid/Buttock/Forearm Fat Grafting, Abdominoplasty, Surgical Gynecomastia Management, Penis Augmentation - including lengthening, Leg Lengthening using the Ilizarov, and various reconstructive hand surgeries. I am not big on body implants with the occassional exception of the calf implant.
 
Last edited:
to_stop_da_cope

to_stop_da_cope

THE NEW BIGBICEPS
Joined
Oct 3, 2020
Posts
3,400
Reputation
3,605
Time online
19d 13h 8m
This week I will be catching up on DMs after my break which lasted about 2 weeks. Between here, Lookism and the snapchat line I have abotu 75 to get through so probably some time next week.



The face is the chief seat of beauty and my main focus.

However I am still knowledgable in Liposuction, Calf/Bicep/Deltoid/Buttock/Forearm Fat Grafting, Abdominoplasty, Surgical Gynecomastia Management, Penis Augmentation - including lengthening, Leg Lengthening using the Ilizarov, and various reconstructive hand surgeries. I am not big on body implants with the occassional exception of the calf implant.
hmmm good, so I can send you my face and you would write your surgery suggestions in ~ 2 week period?
 
Hunterslayer

Hunterslayer

Truth seeker
Joined
Feb 20, 2020
Posts
3,197
Reputation
3,425
Time online
67d 12h 29m
This week I will be catching up on DMs after my break which lasted about 2 weeks. Between here, Lookism and the snapchat line I have abotu 75 to get through so probably some time next week.



The face is the chief seat of beauty and my main focus.

However I am still knowledgable in Liposuction, Calf/Bicep/Deltoid/Buttock/Forearm Fat Grafting, Abdominoplasty, Surgical Gynecomastia Management, Penis Augmentation - including lengthening, Leg Lengthening using the Ilizarov, and various reconstructive hand surgeries. I am not big on body implants with the occassional exception of the calf implant.
Please become top tier surgeon as soon as possible and be rich
 
RealSurgerymax

RealSurgerymax

From .net
Joined
Jul 24, 2020
Posts
546
Reputation
890
Time online
13d 20h 14m
hmmm good, so I can send you my face and you would write your surgery suggestions in ~ 2 week period?
Yes. BUt be sure to include everything - static frontals, quarter shots and TRUE side profiles not head turned against body which everyone seems to do 100% of the time
 
Hunterslayer

Hunterslayer

Truth seeker
Joined
Feb 20, 2020
Posts
3,197
Reputation
3,425
Time online
67d 12h 29m
Mods please pin this thread to best of the best

Actually pin all Surgerymaxx posts he ever write on this forum
 
lasthope

lasthope

Knowledgable
Joined
Nov 11, 2018
Posts
699
Reputation
330
Time online
32d 19h 55m
Mods please pin this thread to best of the best

Actually pin all Surgerymaxx posts he ever write on this forum
This. I legit check all his posts and previous posts
You can learn more from him then the rest of Forum combined
 
6’1cel

6’1cel

CEO of ogre department (DANGEROUSLY HIGH T) ☣️😡
Joined
Oct 4, 2020
Posts
4,621
Reputation
5,087
Time online
24d 15h 4m
Hello Everyone,
In the last year Shoulder Widening has become a big topic on the forums and last week Leif Rogers published a new procedure on YouTube, although I haven't seen anything in the journals yet.

Shoulder Reduction Surgery for the MtF Plastic Surgery population has shown us that clavicle length can be modified which has a direct effect on shoulder width with good predicatble outcomes, with reasonable recovery, as a low-risk outpatient procedure.

Almost all Elective Aesthetic Surgeries are derived from the reconstructive. Shoulder widening surgery was first performed on children with congenitally short clavicles which affected form and function to an extent corrective surgery was warranted. In one case, the surgeon used a Distraction Osteogenesis and in the other, Iliac (hip) Bone Grafts to widen their clavicles.

Now, aesthetic shoulder widening, on an elective basis has come about. You have a few options: Iliac Crest Graft, Fibula Graft, Sliding Clavicle Osteotomy, Distraction Osteogeneis, and Alloplastic Interpositional Bone Implant (PEEK, Theoretical). I will explain them for you below:

Interpositional Bone Graft Option 1 - Iliac (Hip) Harvest
This is the osteotomy used by pediatric reconstructive surgery but could be used in an adult as well. The Iliac Crest is a common bone harvest site for Plastic and Maxillofacial Surgeries and leaves a scar on the side of your hip.

Two small (3cm) skin incisions at the bottom of your neck are made and your clavicles are divided with a saw. The blocks of bone cut from the crest of the hip are inserted between the divided ends of the collar bone, essentially lengthening it, plated with special clavicle plates and closed. The bone graft is integrated into the new clavicle and the edges smooth over the course of about a year when plates can be removed if desired.

The downside to this procedure is the scar and possible irregularity left at the hip harvest site - although if performed bilaterally under a modified technique could be viewed as a good thing for those who desire fip narrowing (although this effect would be minimal if at all noticeable, and certainly limited as the lower hip remains just as wide.)

As with any free bone graft there are risks of infection and loss of the graft.


Maximum Widening: About 2cm Bilaterally, limited by the harvest site.
Other Effects: Shoulders Roll Backward (Aesthetically Viewed positively)

Interpositional Bone Graft Option 2 - Fibula (Lower Leg) Harvest
This is one of the the versions proposed by Dr Eppley as a modification of the above procedure. He talks about it in many places on his blog and and Q&A.

The lower leg has 2 bones, the Tibia and the Fibula. Plastic and Maxillofacial Surgeons commonly harvest the fibula to reconstruct a new mandible (for those who unfortunately lost their lower jaw to cancer or trauma to a rarer extent.) The Tibia supports about 85% of the load placed on it, so loss of the fibula can be adjusted to very well, particularly by young, healthy and highly motivated people. Many of these Jaw Reconstruction patients are substance abusers, in poor health and of more advanced age than most people here who are mostly ASA Class I. Further the surgery to the harvest site would be much less extensive than in the mandibular reconstruction version since less bone is needed, and also that the mandibular reconstruction also removed an entire paddle of skin and muscle.

As above, this is another bone graft. The small risk of infection and possible bone loss necessitating reoperation still applies. It is superior in that the graft site provides the possibility for more lengthening. Being a long bone, the limitation is set by literally how much the shoulder can be widened without injuring the related muscles, ligaments and nerves and that is about 2.5cm bilaterally, possibly up to 3cm in some people.

Maximum Widening: About 2.5cm Bilaterally, limited by the related soft tissues ability to strecth without injury.
Other Effects: Shoulders Roll Backward (Aesthetically Viewed positively)

Interpositional Bone Graft Option 3 - Allogenic (Cadaver Bone)
This option is similar to the methods described above, exceot instead of using your own bone (Autologous) it uses a block cadaver bone matrix which your own bone will grow into and across.

It may be a more inferior option to an autologous graft. Much has been written about Autologous Bone Grafts (Rib, Iliac, Fibula, Calvarial) vs. Allogenic Bone. Which is better depends on the application. Unfortunately when it comes to clavicle lengthening, we just don't know yet.


Maximum Widening: About 2.5cm Bilaterally (Possibly with more resorption), limited by the related soft tissues ability to strecth without injury.
Other Effects: Shoulders Roll Backward (Aesthetically Viewed positively)

Sliding Clavicle Osteotomy
Most Recently, Leif Rogers published a YouTube video performing his method of Clavicle Lengthening. Think of it as a BSSO of the Clavicle. The Osteotomy is made at a slant and it is slid on itself to lengthen the shoulders. When I first heard about this, my concern was that the bone will be too thin where the two divided sides are left in contact. While they do seem thin to me, not necessarily unacceptably so, and he places some Allogenic Bone Putty (allogenic bone discussed above) over the osteotomy for the bone to grow into as it heals.

The advantages of this method is reduced risk of bone graft infection and bone loss (if the putty got infected it would not jeopardize the result as much as an interpositional bone graft becoming infected) as well as no need for a harvest site (no scar or recovery involved at the hip or lower leg.

The only disadvantage is a smaller amount of widening, 1.5 to 2cm. This is still an adequate and noticeable improvement. Here is the video:

Maximum Widening: About 1.75cm Bilaterally, limited by the the need for enogh bone to be in contact on both sides of the sliding osteotomy
Other Effects: Shoulders Roll Backward (Aesthetically Viewed positively)

Distraction Osteogenesis
This is another technique which has been used before in the reconstructive world. The advantage is the Distraction Histogensis (Soft Tissue Stretching and Regeneration including nerves) which occurs with the Distraction Osteogeneis (Bone Regeneration between the osteotomy.)

The downsides are higher complication, longer recovery and the tendency for the clavicles to roll forward which gives a sad or beaten look/stance. This could potentially be mitigated with a Lengthening-Over-Nail approach which is used in Leg Lengthening sometimes. Intermedulary nails of the clavicle can be technically challenging to place though and now crosses the realm into Orthopedic Surgery and not Plastic Surgery.

Here is an external Long bone Distractor (Depicts a femur but this method was applied to the clavicles)
Maximum Widening: 3.5cm or more
Other Effects: Shoulders Roll Forward (Aestheticly Viewed Negatively)

Interpositional Alloplastic Implant (Theoretical and not recommended)
Many people might be wondering now if you could just use some non-living material to lengthen the clavicle. The answer is technically yes, if you had to, but it would not be preferred. Even if it worked well after the recovery it could cause problems later in life as bones get weaker.

For shits and giggles there are two similar applications used in Spinal Surgery and by Plastic Surgeons in Chest Wall Reconstructions.

Porous PEEK Implants are used in Vertebral Implants which allow bone ingrowth and work well. Further, entire rib cages including the sternum have been replaced with 3d Printed PEEK:

holy fuck!
wider shoulders AND more narrow hips as a bonus
 
A

AlmostPerfect

Trainee
Joined
Sep 30, 2020
Posts
13
Reputation
8
Time online
10h 39m
Keep in mind you can also do a sliding clavicle osteotomy more than one to get the desired length. If I had the money I would do that twice rather than a bone graft. Maybe the price would come down if more surgeons offered it.
I would also imagine that if you're a bigger guy with decent clavicles you could get more width with the cut rather than if you had smaller clavicles to start with.
 
to_stop_da_cope

to_stop_da_cope

THE NEW BIGBICEPS
Joined
Oct 3, 2020
Posts
3,400
Reputation
3,605
Time online
19d 13h 8m
Keep in mind you can also do a sliding clavicle osteotomy more than one to get the desired length. If I had the money I would do that twice rather than a bone graft. Maybe the price would come down if more surgeons offered it.
I would also imagine that if you're a bigger guy with decent clavicles you could get more width with the cut rather than if you had smaller clavicles to start with.
how expensive is that?
 
RealSurgerymax

RealSurgerymax

From .net
Joined
Jul 24, 2020
Posts
546
Reputation
890
Time online
13d 20h 14m
Keep in mind you can also do a sliding clavicle osteotomy more than one to get the desired length. If I had the money I would do that twice rather than a bone graft. Maybe the price would come down if more surgeons offered it.
I would also imagine that if you're a bigger guy with decent clavicles you could get more width with the cut rather than if you had smaller clavicles to start with.
Yes that’s true I forgot to add that and now I can’t edit the main post 😔
 
TITUS

TITUS

Zephir
Joined
Jun 29, 2020
Posts
3,552
Reputation
2,751
Time online
18d 12h 39m
I don't understand why the procedure is so expensive. It seems low risk, low skill compared to other ones that are much cheaper.
 
RealSurgerymax

RealSurgerymax

From .net
Joined
Jul 24, 2020
Posts
546
Reputation
890
Time online
13d 20h 14m
I don't understand why the procedure is so expensive. It seems low risk, low skill compared to other ones that are much cheaper.
I agree, it’s just the supply and demand. When it becomes more common, the price will go down some
 
Uglybrazilian

Uglybrazilian

Neomarxist gigamogger
Joined
May 21, 2020
Posts
3,990
Reputation
6,792
Time online
66d 21h 55m
Shoulder widening is most of the times cope because for your shoulders to be attractive you also need to have a somewhat ideal shape
for example, the nigga on the video's thumbnail has sloped shoulders, even if he widens his shoulders they still wont look good
you want your shoulders to be high and square, like this:
kanoa5.jpg
cody.jpg


that depends heavily on your scapula shape, deltoid muscles insertions and neck length(people with long necks usually have framecel vibes and sloped shoulders)
 
RealSurgerymax

RealSurgerymax

From .net
Joined
Jul 24, 2020
Posts
546
Reputation
890
Time online
13d 20h 14m
Shoulder widening is most of the times cope because for your shoulders to be attractive you also need to have a somewhat ideal shape
for example, the nigga on the video's thumbnail has sloped shoulders, even if he widens his shoulders they still wont look good
you want your shoulders to be high and square, like this:
View attachment 811258View attachment 811259

that depends heavily on your scapula shape, deltoid muscles insertions and neck length(people with long necks usually have framecel vibes and sloped shoulders)
Ah yes I can see you are overly expectant and not a candidate for any surgery
 
16tyo

16tyo

Frauding Jordan Barret's Eye Color
Joined
May 18, 2020
Posts
2,738
Reputation
2,805
Time online
36d 2h 5m
easy looks max i don’t see why anyone wouldn’t do this
 
Hunterslayer

Hunterslayer

Truth seeker
Joined
Feb 20, 2020
Posts
3,197
Reputation
3,425
Time online
67d 12h 29m
I Wonder why they wont also lenghren scapula, they would be able give squarer shoulders also plus results would be probably even better.
 
RealSurgerymax

RealSurgerymax

From .net
Joined
Jul 24, 2020
Posts
546
Reputation
890
Time online
13d 20h 14m
I Wonder why they wont also lenghren scapula, they would be able give squarer shoulders also plus results would be probably even better.
Aside from the Clavicle, the Scapula is a floating bone, so when the Clavicle is lengthened the scapula will move with it to some point limited by the stretching of the soft tissues which includes dense back muscles.

Lenthening the scapula would probably be foolish since it’s not really necessary, and also that The direct surgical access required would cut through and injure back muscles and possibly cause chronic pain and permanent mild disability.

However some people recover from acromion fractures with rigid fixation just fine... a lot of investigation would have to be done to arrive at a confident starting point to do double Clavicle/Scapula Lengthening.
 
Last edited:
MoeZart

MoeZart

Zephir
Joined
May 18, 2020
Posts
2,700
Reputation
4,330
Time online
57d 20h 44m
@Kingkellz sticky this, brother, i almost missed this thread and we have 2/4 threads about dicksize stickyed in here, gotta respect the quality
 
patricknotstar

patricknotstar

Apprentice
Joined
May 24, 2020
Posts
244
Reputation
250
Time online
1d 18h 59m
Hello Everyone,
In the last year Shoulder Widening has become a big topic on the forums and last week Leif Rogers published a new procedure on YouTube, although I haven't seen anything in the journals yet.

Shoulder Reduction Surgery for the MtF Plastic Surgery population has shown us that clavicle length can be modified which has a direct effect on shoulder width with good predicatble outcomes, with reasonable recovery, as a low-risk outpatient procedure.

Almost all Elective Aesthetic Surgeries are derived from the reconstructive. Shoulder widening surgery was first performed on children with congenitally short clavicles which affected form and function to an extent corrective surgery was warranted. In one case, the surgeon used a Distraction Osteogenesis and in the other, Iliac (hip) Bone Grafts to widen their clavicles.

Now, aesthetic shoulder widening, on an elective basis has come about. You have a few options: Iliac Crest Graft, Fibula Graft, Sliding Clavicle Osteotomy, Distraction Osteogeneis, and Alloplastic Interpositional Bone Implant (PEEK, Theoretical). I will explain them for you below:

Interpositional Bone Graft Option 1 - Iliac (Hip) Harvest
This is the osteotomy used by pediatric reconstructive surgery but could be used in an adult as well. The Iliac Crest is a common bone harvest site for Plastic and Maxillofacial Surgeries and leaves a scar on the side of your hip.

Two small (3cm) skin incisions at the bottom of your neck are made and your clavicles are divided with a saw. The blocks of bone cut from the crest of the hip are inserted between the divided ends of the collar bone, essentially lengthening it, plated with special clavicle plates and closed. The bone graft is integrated into the new clavicle and the edges smooth over the course of about a year when plates can be removed if desired.

The downside to this procedure is the scar and possible irregularity left at the hip harvest site - although if performed bilaterally under a modified technique could be viewed as a good thing for those who desire fip narrowing (although this effect would be minimal if at all noticeable, and certainly limited as the lower hip remains just as wide.)

As with any free bone graft there are risks of infection and loss of the graft.


Maximum Widening: About 2cm Bilaterally, limited by the harvest site.
Other Effects: Shoulders Roll Backward (Aesthetically Viewed positively)

Interpositional Bone Graft Option 2 - Fibula (Lower Leg) Harvest
This is one of the the versions proposed by Dr Eppley as a modification of the above procedure. He talks about it in many places on his blog and and Q&A.

The lower leg has 2 bones, the Tibia and the Fibula. Plastic and Maxillofacial Surgeons commonly harvest the fibula to reconstruct a new mandible (for those who unfortunately lost their lower jaw to cancer or trauma to a rarer extent.) The Tibia supports about 85% of the load placed on it, so loss of the fibula can be adjusted to very well, particularly by young, healthy and highly motivated people. Many of these Jaw Reconstruction patients are substance abusers, in poor health and of more advanced age than most people here who are mostly ASA Class I. Further the surgery to the harvest site would be much less extensive than in the mandibular reconstruction version since less bone is needed, and also that the mandibular reconstruction also removed an entire paddle of skin and muscle.

As above, this is another bone graft. The small risk of infection and possible bone loss necessitating reoperation still applies. It is superior in that the graft site provides the possibility for more lengthening. Being a long bone, the limitation is set by literally how much the shoulder can be widened without injuring the related muscles, ligaments and nerves and that is about 2.5cm bilaterally, possibly up to 3cm in some people.

Maximum Widening: About 2.5cm Bilaterally, limited by the related soft tissues ability to strecth without injury.
Other Effects: Shoulders Roll Backward (Aesthetically Viewed positively)

Interpositional Bone Graft Option 3 - Allogenic (Cadaver Bone)
This option is similar to the methods described above, exceot instead of using your own bone (Autologous) it uses a block cadaver bone matrix which your own bone will grow into and across.

It may be a more inferior option to an autologous graft. Much has been written about Autologous Bone Grafts (Rib, Iliac, Fibula, Calvarial) vs. Allogenic Bone. Which is better depends on the application. Unfortunately when it comes to clavicle lengthening, we just don't know yet.


Maximum Widening: About 2.5cm Bilaterally (Possibly with more resorption), limited by the related soft tissues ability to strecth without injury.
Other Effects: Shoulders Roll Backward (Aesthetically Viewed positively)

Sliding Clavicle Osteotomy
Most Recently, Leif Rogers published a YouTube video performing his method of Clavicle Lengthening. Think of it as a BSSO of the Clavicle. The Osteotomy is made at a slant and it is slid on itself to lengthen the shoulders. When I first heard about this, my concern was that the bone will be too thin where the two divided sides are left in contact. While they do seem thin to me, not necessarily unacceptably so, and he places some Allogenic Bone Putty (allogenic bone discussed above) over the osteotomy for the bone to grow into as it heals.

The advantages of this method is reduced risk of bone graft infection and bone loss (if the putty got infected it would not jeopardize the result as much as an interpositional bone graft becoming infected) as well as no need for a harvest site (no scar or recovery involved at the hip or lower leg.

The only disadvantage is a smaller amount of widening, 1.5 to 2cm. This is still an adequate and noticeable improvement. Here is the video:

Maximum Widening: About 1.75cm Bilaterally, limited by the the need for enogh bone to be in contact on both sides of the sliding osteotomy
Other Effects: Shoulders Roll Backward (Aesthetically Viewed positively)

Distraction Osteogenesis
This is another technique which has been used before in the reconstructive world. The advantage is the Distraction Histogensis (Soft Tissue Stretching and Regeneration including nerves) which occurs with the Distraction Osteogeneis (Bone Regeneration between the osteotomy.)

The downsides are higher complication, longer recovery and the tendency for the clavicles to roll forward which gives a sad or beaten look/stance. This could potentially be mitigated with a Lengthening-Over-Nail approach which is used in Leg Lengthening sometimes. Intermedulary nails of the clavicle can be technically challenging to place though and now crosses the realm into Orthopedic Surgery and not Plastic Surgery.

Here is an external Long bone Distractor (Depicts a femur but this method was applied to the clavicles)
Maximum Widening: 3.5cm or more
Other Effects: Shoulders Roll Forward (Aestheticly Viewed Negatively)

Interpositional Alloplastic Implant (Theoretical and not recommended)
Many people might be wondering now if you could just use some non-living material to lengthen the clavicle. The answer is technically yes, if you had to, but it would not be preferred. Even if it worked well after the recovery it could cause problems later in life as bones get weaker.

For shits and giggles there are two similar applications used in Spinal Surgery and by Plastic Surgeons in Chest Wall Reconstructions.

Porous PEEK Implants are used in Vertebral Implants which allow bone ingrowth and work well. Further, entire rib cages including the sternum have been replaced with 3d Printed PEEK:

It is the overall thickness and width of the torso that gives a masc frame , not some gay alien skull model with 747 clavicles
 
RealSurgerymax

RealSurgerymax

From .net
Joined
Jul 24, 2020
Posts
546
Reputation
890
Time online
13d 20h 14m
It is the overall thickness and width of the torso that gives a masc frame , not some gay alien skull model with 747 clavicles
You can build that up with bodybuilding.

Surgery is not perfect but has solutions for improvement. Take it or leave it.
 

Similar threads

Users who are viewing this thread

  • trpsweden
Top