Can Surgery Improve Shoulder Appearance After Congenital Scapular Elevation?

Can surgical intervention for congenital high scapula improve the appearance of the shoulder?

I'm sorry to hear about your brother's situation.
He can consult with an orthopedic surgeon or a plastic surgeon who specializes in reconstructive surgery.
They can evaluate his condition and discuss potential surgical options to improve the appearance of his shoulders.
Additionally, a consultation with a physical therapist may also be beneficial to explore non-surgical options for improving shoulder symmetry and strength.

Cai Xiaojie, 20~29 year old female. Ask Date: 2021/10/19

Dr. Wang Shouji reply Orthopedics

Hello, if there is no shoulder joint mobility impairment, treatment is not recommended.
Surgery is only suggested if it affects shoulder joint mobility.
Therefore, these symptoms are often due to congenital multifactorial causes, commonly including thoracic spine deformities, and most interventions are focused solely on the impaired mobility.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2021/10/19

More Info

When it comes to congenital scapular elevation, also known as Sprengel's deformity, surgical intervention can indeed play a significant role in improving both the functional and aesthetic aspects of the shoulder. Your brother's experience with surgery at a young age likely addressed the elevation of the scapula, but as he has grown, the asymmetry in shoulder width may still be noticeable. This can lead to self-esteem issues, as you mentioned.

To address your question about which specialty to consult, I recommend starting with a board-certified orthopedic surgeon who specializes in shoulder and upper extremity surgery. They will have the expertise to evaluate the current state of your brother's shoulders and determine whether further surgical intervention is appropriate. Additionally, a plastic surgeon with experience in reconstructive surgery could also provide valuable insights, especially if aesthetic improvement is a primary concern.

There are several surgical options that may be considered to improve shoulder appearance and symmetry:
1. Scapular Repositioning Surgery: If the scapula is still positioned higher than normal, a surgeon may perform a procedure to reposition it. This can help in achieving a more balanced appearance.

2. Shoulder Augmentation: In some cases, if one shoulder appears narrower due to muscle atrophy or other factors, a surgeon might consider procedures to augment the shoulder, such as fat grafting or implants.

3. Muscle Transfer: If there is significant muscle imbalance, a surgeon may recommend transferring muscles from other areas to improve the function and appearance of the shoulder.

4. Physical Therapy: While not a surgical option, engaging in a structured physical therapy program can help strengthen the muscles around the shoulder, potentially improving symmetry and function. A physical therapist can design a program tailored to your brother's specific needs.

5. Reconstructive Surgery: If there are significant deformities or functional limitations, reconstructive surgery may be an option. This would involve a more complex surgical approach to restore both function and appearance.

It's important to have a thorough evaluation, including imaging studies such as X-rays or MRIs, to assess the current condition of the shoulder girdle and surrounding structures. This will help the surgeon determine the best course of action.

In terms of recovery and outcomes, the success of any surgical intervention will depend on various factors, including the specific procedure performed, the surgeon's expertise, and your brother's overall health and commitment to rehabilitation. Post-operative physical therapy is often crucial for achieving the best results, as it helps to strengthen the shoulder and improve range of motion.

Lastly, it's essential to have realistic expectations regarding the outcomes of surgery. While surgical options can significantly improve appearance and function, complete symmetry may not always be achievable. Open communication with the surgical team about goals and concerns will be vital in making informed decisions about the best approach for your brother's situation.

In summary, consulting with an orthopedic or plastic surgeon specializing in shoulder conditions is the best next step. They can provide a comprehensive evaluation and discuss potential surgical options to improve both the appearance and function of your brother's shoulders.

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