Shoulder Reduction Surgery

(Clavicle Shortening for Shoulder Width Narrowing)

at WIH Hospital

Shoulder Reduction Surgery, also called clavicle shortening surgery or shoulder width narrowing, is a specialized cosmetic and gender-affirming procedure that reduces the width of the shoulders by removing a small segment of the clavicle bone (collarbone) on both sides. The remaining ends are then aligned and stabilized using titanium plates and screws. This safe and effective surgical technique creates a narrower shoulder span, resulting in a more balanced and aesthetically feminine silhouette — especially for patients seeking body feminization surgery.

Shoulder width narrowing is a powerful body feminization surgery designed to reduce the broad shoulder span and create a softer, more proportionate upper body shape. This surgery can benefit both transgender women and cisgender women who feel their shoulders are too wide, masculine, or disproportionate to the rest of their body.

At WIH International Hospital, Dr. Chettasak and his expert surgical team specialize in advanced feminization procedures that help patients achieve their ideal body shape — safely, precisely, and beautifully.

Based on Dr. Chettasak’s extensive clinical experience, approximately 70% of shoulder reduction surgery patients at WIH are transgender women who seek a more feminine upper body contour. Many patients choose to combine clavicle shortening with other MTF body feminization procedures, such as breast augmentation, rib cage narrowing (rib modeling), and waist liposuction, to achieve an hourglass silhouette. This all-in-one approach enhances proportions, streamlines recovery, and provides transformative results — all performed by a highly skilled and trusted surgical team.

How Much Shoulder Width Can Be Reduced with Shoulder Reduction Surgery?

One of the most frequently asked questions about shoulder reduction surgery (also known as shoulder width narrowing or clavicle shortening) is how much bone can be safely removed — and how visible the change will be.

At WIH International Hospital, Dr. Chettasak and our surgical team typically remove an average of 2.5 cm of clavicle bone from each side, with a range between 2 to 3 cm depending on your body frame and original shoulder width. This amount is carefully planned to balance visible aesthetic results with safe recovery and normal shoulder function.

What Change Will You See?

The visible narrowing of the shoulders comes from two effects:

  • Horizontal shortening of the clavicle bone (removing 2–3 cm per side)
  • Mild forward rotation of the shoulders, which helps round out the contour and creates a more feminine silhouette

These combined effects can create a noticeable narrowing of the upper body, especially when viewed from the front. Importantly, the forward rotation is subtle and does not affect arm mobility or shoulder strength.

Surgical Technique for Shoulder Reduction (Clavicle Shortening)

The surgical approach for clavicle shortening begins with a small, well-planned incision approximately 1.5 to 2 centimeters in length, carefully placed in the supraclavicular fossa over the medial third of the clavicle. This location provides optimal access while minimizing visible scarring. Once the clavicle is exposed through meticulous skeletonization, an initial bone cut is made medially using an oscillating saw. To determine the precise length of bone to be removed, the shoulder is gently adducted inward to simulate the desired postoperative alignment. The overlap created between the cut medial end and the intact lateral clavicle is marked, guiding the subsequent lateral cut and ensuring symmetry in bone removal on both sides.

After removing the targeted bone segment, fixation begins with the placement of a small titanium plate along the inferior surface of the clavicle to align and stabilize the bone ends. This step is followed by the application of a larger Dynamic Compression Plate (DCP) on the superior surface to complete rigid fixation, ensuring proper healing and restoring shoulder stability. The incision is then closed in two layers using absorbable sutures, with an intradermal technique employed to promote a smooth, cosmetically refined scar. This comprehensive and precise surgical method allows for predictable outcomes while preserving full shoulder function.

📌 Postoperative X-ray of the clavicles is routinely performed at the first follow-up to confirm proper bone alignment and healing progress.

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Bone gap

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How Safe Is It?

Medical research and orthopedic data show that clavicle shortening in the 2.5 cm range per side does not impair shoulder function or biomechanics. Elective shortening in this range is well within the safety threshold, as it mimics the healing seen in clavicle fracture patients who undergo similar reductions without long-term impact on shoulder movement.

However, shortening the clavicle beyond 3.5 cm bilaterally is not well studied and may pose risks to shoulder mechanics. That’s why at WIH, we stay within a safe 2–3 cm removal range, ensuring optimal results without compromising function.

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Result After Shoulder Width Reduction Surgery

After shoulder width reduction surgery (also known as clavicle shortening), patients can expect a clear and measurable decrease in shoulder span—typically 2 to 3 centimeters per side, depending on body size and bone structure. Beyond the narrower width, the procedure also creates a more rounded and feminine shoulder shape, thanks to the natural forward rotation of the shoulder joints that occurs after bone shortening.

This subtle yet impactful change greatly improves upper body proportions, making the shoulders look delicate, softer, and better aligned with feminine aesthetics. At WIH International Hospital, Dr. Chettasak performs each surgery with meticulous care to preserve normal shoulder function and full range of motion, ensuring both safety and satisfaction.

→ Postoperative X-ray of the clavicles is routinely performed

at the first follow-up to confirm proper bone alignment and healing progress.

→ After Surgery Instructions for Shoulder Width Reduction (Clavicle Shortening)

  • In most cases, the arm sling is recommended for 2–3 weeks, but the exact duration may vary depending on individual activity levels and healing progress.
  • Limit shoulder movement, especially:

→ No lifting your arms out to the side above shoulder level for at least 2 months.

→ This movement is called abduction, which means moving your arm sideways away from your body — like when you stretch your arms out to form a “T” shape. Avoid doing this to protect the healing clavicle.

  • Do not carry heavy items with the operated arms for at least 6–8 weeks.
  • Sleep on your back with pillows to support your arms. Avoid sleeping on your side.
  • Keep the surgical area dry for the first few days. Follow wound care instructions as advised by your doctor.
  • Follow-up appointments are important for checking healing progress and removing sutures if needed.
  • Rehabilitation exercises may begin gradually after 6–8 weeks, as recommended by your surgeon or physical therapist.

Recovery Timeline

  • Weeks 1-2: Use the arm sling consistently. Light activities can be resumed, avoiding any arm elevation or strain.
  • Weeks 3-6: Gradual reduction of arm sling use as advised by the surgeon. Avoid heavy lifting or strenuous activities.
  • Months 2-3: Increased activity as healing progresses. Continue prescribed exercises by the surgeon. Final aesthetic results become more apparent.
  • Beyond 3 Months: Return to full activity under surgeon’s guidance. Full bone healing takes several months, but functional recovery is usually much faster.

Frequently Asked Questions (FAQ) about Shoulder Narrowing

Discomfort and pain are expected after surgery, especially in the first few days. This will be managed effectively with prescribed pain medication.

This depends on the nature of your job. For desk jobs or non-strenuous work, you may be able to return within 2 weeks. Jobs requiring physical exertion or heavy lifting will require a longer recovery period, typically 6 weeks or more.

  • Yes, there will be scars, typically 2 cm in length, located above each collarbone. Surgeons at WIH Hospital make every effort to place incisions in less conspicuous areas and use meticulous closure techniques.

  • In most cases, the titanium plates and screws are designed to remain in place permanently. However, if they cause irritation or become palpable, they can be removed in a minor secondary procedure once the bone has fully healed.

  • The goal is to narrow the shoulders without significantly compromising function. While there will be temporary restrictions on movement, and some initial weakness during recovery.

  • All surgeries carry some risks. However, when performed by a qualified and experienced surgeon in an accredited facility at WIH Hospital, shoulder reduction is typically regarded as safe.

  • We recommend staying 12–15 days after surgery for safe recovery and follow-up care. Our team at WIH Hospital is here to support international patients throughout their stay.

Trust WIH International Hospital to provide safe, natural, and beautifully balanced results.