Aesthetic surgery of the shoulder largely revolves around shoulder narrowing for females and shoulder lengthening/augmentation for men. In reductive shoulder surgery in females the goal is to make the shoulders less broad and to change its shape to have a less square/masculine in appearance. While the primary focus is on the outer shape of the shoulders some women may also have concerns about the appearance of their shoulder blades in that certain parts of it may stick out more than desired.
The shoulder blades or the scapula is the triangular flat bone on the upper back that connects the humerus bone of the upper arm to the clavicles largely through the rotator cuff attachments. The major muscle groups of the trapezius and deltoid also attach to the scapula. On its visible back surface it has four landmarks that may be visible, the longer medial edge, the lateral edge, the tip (inferior angle) and the spine. The spine is usually the most visible landmark as it runs from the upper outer part of the scapula obliquely across its upper surface. The most prominent area of the spine has known as the deltoid tuberosity. As the name indicates this is the most medial area of the tendinous attachment of the deltoid muscle.
A scapular shave procedure is a reduction of the most prominent part of the deltoid tuberosity. This is done through two small incisions located directly over them.
In the prone position in surgery the scapular bony prominences are exposed with some release of the tendinous attachments. A high speed hand-piece and burr is used to flatten the prominences.
A multilayer closure is done with resorbable sutures and the incisions then covered with glued on tapes.
Such scapular shaves, to date, have been done as part of shoulder narrowing surgery. (clavicle reduction osteotomies) They do not add to the recovery from the clavicle reductions as the amount of muscle detachment is limited.
Dr. Barry Eppley
World-Renowned Plastic Surgeon