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

[lasthope]

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]

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.

View attachment 809449​

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

 

[AlmostPerfect]

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.

 

[Rich/Jewish_Gooner$]

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]

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

 

[RealSurgerymax]

how expensive is that?

It is rather expensive it would cost nearly 100K to have it done twice

 

[TITUS]

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]

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]

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:

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]

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

 

[Uglybrazilian]

Ah yes I can see you are overly expectant and not a candidate for any surgery

?

 

[recessed]

Only worth it if you have legit truecel frame.
For everyone else it is like LL for 6'+

 

[Deleted member 7076]

easy looks max i don’t see why anyone wouldn’t do this

 

[Deleted member 5385]

I Wonder why they wont also lenghren scapula, they would be able give squarer shoulders also plus results would be probably even better.

 

[RealSurgerymax]

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.

 

[lasthope]

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

Any update?

 

[Deleted member 7098]

@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]

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.

View attachment 809449​

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]

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.

 

[patricknotstar]

You can build that up with bodybuilding.

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

Solution to enter uncanny valley

 

[sandcelmuttcel]

lmao fuck this bullshit just blast hgh shoulder growth plates are open until late 20's I believe

 

[MewingJBP]

peak autism

 

[Robocok]

Lateral raises and side planks. Blows me away how dumb y'all are.

 

[randomuser2407]

Like with anything else, there are pros and cons of having a wide frame. The wider you are, the more thin you will look like. This is why guys who have a narrow frame have much thicker lats than those who have a wide frame. Frame doesn't matter unless you are competing in bodybuilding because there are pros and cons on each side of the spectrum, so there are no winners and losers.

 

[randomuser2407]

Lateral raises and side planks. Blows me away how dumb y'all are.

Lateral raises build the side delts, not the lats. The side delts can never grow enough to make an big enough difference unless you use steroids. Since chin ups and pullups are the best at building lats, that is the exercise that you should do, not lateral raises, and definitely not side planks. Side planks only build the hip flexors and not by much since you need added resistance to grow your core.

You're the dumb one.

 

[EverythingMattersCel]

Like with anything else, there are pros and cons of having a wide frame. The wider you are, the more thin you will look like. This is why guys who have a narrow frame have much thicker lats than those who have a wide frame. Frame doesn't matter unless you are competing in bodybuilding because there are pros and cons on each side of the spectrum, so there are no winners and losers.

Not true. There are no diminishing returns of shoulder-waist ratio until 1.8+. There are studies proving this.

 

[EverythingMattersCel]

Lateral raises build the side delts, not the lats. The side delts can never grow enough to make an big enough difference unless you use steroids. Since chin ups and pullups are the best at building lats, that is the exercise that you should do, not lateral raises, and definitely not side planks. Side planks only build the hip flexors and not by much since you need added resistance to grow your core.

You're the dumb one.

I agree with you on growing back. So many normies neglect back. It's the biggest thing for making your "frame" look big in a shirt yet so many here are fixated on growing delts.

 

[randomuser2407]

Not true. There are no diminishing returns of shoulder-waist ratio until 1.8+. There are studies proving this.

The narrower your frame is, the more stocky you will look, the wider your frame is, the less stocky you will look. You are confusing wingspan with frame size, just because someone has a smaller wingspan doesn't mean their frame is smaller, otherwise I wouldn't look so skinny at 170 lbs at 6 foot 4 with my narrow frame.

Your frame size is only dependent on your height, the taller you are, the more you will weigh. But wingspan is a completely separate thing, you can have a small wingspan as a tall guy but you can't have a manlet body when you are tall, it would be a complete contradiction to say such a thing because the taller you are, the longer your muscle insertions are, so the bigger your frame is.

 

[EverythingMattersCel]

The narrower your frame is, the more stocky you will look, the wider your frame is, the less stocky you will look. You are confusing wingspan with frame size, just because someone has a smaller wingspan doesn't mean their frame is smaller, otherwise I wouldn't look so skinny at 170 lbs at 6 foot 4 with my narrow frame.

Your frame size is only dependent on your height, the taller you are, the more you will weigh. But wingspan is a completely separate thing, you can have a small wingspan as a tall guy but you can't have a manlet body when you are tall, it would be a complete contradiction to say such a thing because the taller you are, the longer your muscle insertions are, so the bigger your frame is.

You're forgetting to factor ribcage into the equation. A bigger ribcage can offset the freaky y-taper look that comes from broad shoulders and a tiny waist.

"Frame" is loosely defined here but it encompasses delt size + biacromial (bideltoid length) and clavicle breadth (biacromial length) . How low your lat insertion is... a low lat insertion = massive back otherwise you will be destined forever to a small back.

Yes, on average taller people have bigger frames but it's not a linear relationship. Some tall people have a low bideltoid length and some shorter people have a longer bideltoid. Also, bigger frame does not correlate 100% to aesthetics either. A shorter person with a smaller waist circumference and good insertions will mog a tall ogre that has shit proportions. A lot to consider...

 

[randomuser2407]

You're forgetting to factor ribcage into the equation. A bigger ribcage can offset the freaky y-taper look that comes from broad shoulders and a tiny waist.

"Frame" is loosely defined here but it encompasses delt size + biacromial (bideltoid length) and clavicle breadth (biacromial length) . How low your lat insertion is... a low lat insertion = massive back otherwise you will be destined forever to a small back.

Yes, on average taller people have bigger frames but it's not a linear relationship. Some tall people have a low bideltoid length and some shorter people have a longer bideltoid. Also, bigger frame does not correlate 100% to aesthetics either. A shorter person with a smaller waist circumference and good insertions will mog a tall ogre that has shit proportions. A lot to consider...

You're not even talking about frame size then, you're talking about proportions according to pro-bodybuilding standards.

What judges in bodybuilding shows consider to be attractive is not the same as what societies consider to be attractive. Only the biggest fanatics of that sport will care about the fine details of having a wide frame and perfect insertions, the vast majority of women do not care about that at all, they only care about the size of your muscles and how proportional they are to the rest of your body. A guy who has a huge upper body and tiny legs will look cartoonish, and it's the same with those who have the opposite thing. And although there is such a thing as too skinny, there is also such a thing as too fat or too muscular, but what is considered most attractive will vary from person to person.

When speaking of frame size however, it is only dependent on height because, the taller you are, the more you will weigh. Of course, you think that because some tall men are more narrow than shorter men or have some body parts which are smaller that they would weigh the same as shorter men, but it simply isn't the case, it's just that some of their body parts may be much larger than usual to compensate.

As a 6 foot 4 guy, I have long legs but a smaller torso, most of my height is in my legs not in my torso, so when people see me for the first time when I am sat down on a bench, they think I am as short as they are, but it is only an illusion that is easily broken when I stand up.

You believe that frame size isn't dependent on height because you are fooled by that illusion.

It is very important to understand this concept of frame because it allows you to finally find the weight that you need to be at to look good. I know that until I reach 190 or 200 lbs, I will always look skinny no matter how much muscle mass I gain from 170 lbs, and I know that at my peak I would be at 220 lbs at around 12% body fat even though I am only 170 lbs right now.

But according to you, because I am narrow, then my frame is small and I shouldn't play by the dieting rules of a tall guy and should aim lower, that is why you are wrong.

 

[compbio]

My clavicles are sloped downwards. Would it be possible to alter the clavicle angle during a sliding clavicle osteotomy?

 

[RealSurgerymax]

My clavicles are sloped downwards. Would it be possible to alter the clavicle angle during a sliding clavicle osteotomy?

It could be attempted but it will probably relapse, to what degree is not yet known.

 

[Robocok]

Lateral raises build the side delts, not the lats. The side delts can never grow enough to make an big enough difference unless you use steroids. Since chin ups and pullups are the best at building lats, that is the exercise that you should do, not lateral raises, and definitely not side planks. Side planks only build the hip flexors and not by much since you need added resistance to grow your core.

You're the dumb one.

Lats give you a v-taper which is important. Side planks tone the hip flexors which, along with a low enough body fat percentage, will make your waist narrower.

Later raises will grow the shoulder. Saying that only steroids will make a noticeable difference is stupid and a cope for your poor training results.

Dumbass

 

[compbio]

Lats give you a v-taper which is important. Side planks tone the hip flexors which, along with a low enough body fat percentage, will make your waist narrower.

Later raises will grow the shoulder. Saying that only steroids will make a noticeable difference is stupid and a cope for your poor training results.

Dumbass

Side planks primarily target the obliques, not the hip flexors. If the obliques hypertrophy, this will make your waist larger, not smaller.

 

[Robocok]

Side planks primarily target the obliques, not the hip flexors. If the obliques hypertrophy, this will make your waist larger, not smaller.

Side planks are a static, bodyweight exercise to tone and tighten that will not cause any significant hypertrophy.

 

[Deleted member 10449]

@RealSurgerymax assuming one does the fibula graft and manages to lengthen 3cm per side, in your opinion how possible is it to return to sports afterwards? because with LL for example 6cm total lengthening would already cause significant loss of athletic ability to most people, though the clavicle does not bear as much weight as the legs

 

[Deleted member 10449]

Also something that is not discussed and it seems as if Eppley and Rogers intentionally skip to talk about, would 5 or 6cm lengthning of clavicles actually equate to a 5 or 6cm increased bichromial width? I would expect less gain than that

 

[RealSurgerymax]

@RealSurgerymax assuming one does the fibula graft and manages to lengthen 3cm per side, in your opinion how possible is it to return to sports afterwards? because with LL for example 6cm total lengthening would already cause significant loss of athletic ability to most people, though the clavicle does not bear as much weight as the legs

You should be able to at 1-year post op, or even less.

Also something that is not discussed and it seems as if Eppley and Rogers intentionally skip to talk about, would 5 or 6cm lengthning of clavicles actually equate to a 5 or 6cm increased bichromial width? I would expect less gain than that

It should translate to abut 85% to 90% of the bone graft length but not enough is known at this time. Clavicle Reduction is much more common and it is well known that the effect is close to 1:1

 

[Deleted member 10449]

You should be able to at 1-year post op, or even less.



It should translate to abut 85% to 90% of the bone graft length but not enough is known at this time. Clavicle Reduction is much more common and it is well known that the effect is close to 1:1

Thanks for the info man

 

[98Zdeed98]

doesn't clavicle lengthening rotate them inwards? please respond

 

[RealSurgerymax]

doesn't clavicle lengthening rotate them inwards? please respond

If anything they will rotate back.

Only Distraction Osteogensis Clavicle Lengthening may rotate forward (in my opinion a sort of beaten look), unless you somehow find a way to do LON (Lengthening Over Nails)

 

[Deleted member 10449]

If anything they will rotate back.

Only Distraction Osteogensis Clavicle Lengthening may rotate forward (in my opinion a sort of beaten look), unless you somehow find a way to do LON (Lengthening Over Nails)

Distraction osteogenesis sounds pretty extreme like sth only FtM would do

A man with average clavicle would probably get too big of clavicles already from a 6 cm increase, I d suspect more could end up looking comical

 

[bimaximum]

Very interesting.
Where can we find some results online ?

 

[TRNA]

does anyone know how much this would cost, I'd love to get this in the future to get a mogger Superman frame, instead of the swimmer's frame I have currently

 

[Deleted member 10449]

does anyone know how much this would cost, I'd love to get this in the future to get a mogger Superman frame, instead of the swimmer's frame I have currently

27k eppley
51k leif rogers

 

[Ijustwannafuckbitche]

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.

View attachment 809449​

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.

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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.

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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:

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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:

Do you know if it clavicle lengthening widens the point at which the arms begin, therefore increasing wingspan?

 

[RealSurgerymax]

Do you know if it clavicle lengthening widens the point at which the arms begin, therefore increasing wingspan?

Yes it does.

 

[Ijustwannafuckbitche]

How? Doesn't the scapula stay in the same place?

Yes it does.

 

[Deleted member 4797]

Yes it does.

What effect does this have on the chest from the front? Does the muscle look more flared out at the upper chest, like this effect?

(morph which moves, click image to see movements)

 

[Deleted member 1862]

What effect does this have on the chest from the front? Does the muscle look more flared out at the upper chest, like this effect?

(morph which moves, click image to see movements)

this would be great, but sadly it won't do this