The shoulder joint is bony connected to the rib cage only via the clavicle. The width of the shoulder thus depends essentially on the length of the clavicles, which as articulated intermediate links determine the distance to the sternum. After a fracture, it can happen that the clavicle bone heals together under shortening, so that this results in asymmetry, which leads to poor posture and tension in the shoulder area during many symmetry-demanding activities of daily life. In addition, there are also congenitally too short variants of the clavicles on both sides, which manifests itself in a "narrow" shoulder. There is also a cosmetic desire for somewhat wider or narrower shoulders.
If your elbow sticks out from your body when your arm hangs down or you constantly feel a padding in your armpit, you should check if there is a disproportion to your bony chest by measuring your collarbones. A clavicle lengthening can solve the problem if necessary.
Only in rare cases, when there is a congenital mismatch of shoulder width to rib cage width, is there a medical indication for shoulder widening. Much more frequently, the desire for shoulder widening is expressed by men who are dissatisfied with their appearance, so that the treatment falls into the cosmetic area. Conversely, a shoulder that is too wide is perceived by some women as "too masculine", so that a narrowing is desired. As little as 1-2 cm on each side will result in a significantly altered appearance for both a widening and a narrowing. Especially in the case of a narrowing, this is the limit of what is possible anyway, because otherwise there will be functional impairments due to the chest.
Surgical length corrections of the clavicles also fall within the area of expertise of ZEM-Germany. In most cases, 1-2 cm are sufficient to achieve a functional gain or to permanently change the appearance. These corrections can be performed acutely in a minimally invasive technique during surgery by cutting the clavicle and attaching a small plate for stabilization. If there is a need for more extensive lengthening, such as after an accident, an external fixator must be used to continuously pull the clavicle apart. Cosmetic clavicle lengthening or shortening is usually performed acutely on both sides as part of one operation, which is also more advantageous in terms of scarring.
Depending on the initial findings and degree of difficulty, a bilateral length correction of the clavicles (shortening or lengthening) costs between 25,000€ and 35,000€. In the case of a cosmetic indication, the current value added tax is also due.