Is there a way to reduce the width of my shoulders other than Botox?

Question

I am MTF trans and also played sports in college so my shoulder width is my biggest problem area. Other than Botox, is there a surgery or intervention I can do to effectively reduce the width of my shoulders/shoulder blades? Thanks

Anna Chacon, MD, FAAD · Answer

Yes, there are options besides Botox for reducing shoulder width, though they vary in availability, risk, and effectiveness. Here's a breakdown:

1. Surgical Option: Clavicle Shortening Surgery (Clavicle Resection)
What it is: A procedure that removes a small portion (usually 2–3 cm total) of each clavicle to slightly narrow shoulder width.

Effectiveness: Can reduce shoulder breadth by approximately 1–2 inches depending on anatomy.

Risks/Considerations:

Invasive surgery with potential complications such as nerve damage, infection, or impaired shoulder function.

Recovery may involve physical therapy and movement restrictions.

Cosmetic surgeons or gender-affirming specialists with experience in skeletal contouring usually perform this.

Availability: Not commonly performed and may be difficult to find a qualified provider.

2. Muscular Reduction Over Time
How it works: Since your shoulder width may be partly due to developed deltoid and trapezius muscles (from sports), stopping upper body strength training and focusing on estrogen therapy can lead to muscle atrophy over time.

Effectiveness: Gradual and limited but can soften shoulder contours, making them appear narrower.

Tools: Estrogen, anti-androgens, and physical deconditioning from muscle-building exercises may help.

3. Posture & Visual Contouring (Non-Surgical)
Clothing Choices: Tops with rounded shoulders, raglan sleeves, and darker colors can visually minimize shoulder width.

Posture Coaching: Working with a physical therapist or trainer to modify posture can help reduce broad or “square” shoulder appearance.

4. Botox for Trapezius Slimming (Trapezius Reduction)
You mentioned this, but for clarity: Botox can be used to slim the trapezius muscle, softening the shoulder line. While it doesn’t reduce bone width, it can visually narrow the upper body.

Summary
Clavicle shortening surgery is the only known surgical option to physically reduce shoulder width.

Hormonal therapy and muscle atrophy can offer modest improvements over time.

Visual styling and posture can enhance the overall effect.

Let me know if you’d like a breakdown of what to discuss with a gender-affirming surgeon if you consider clavicle shortening.

James M. Economides, MD, FACS · Answer

Thank you for sharing that with me! Shoulder width is a common concern for many individuals undergoing gender affirmation, especially for those who have an athletic background.

Surgical Options:
While there isn't a specific surgery designed to reduce the bone structure or width of the shoulders, there are a few options that can help address shoulder width and create a more feminized appearance:

Muscle Reduction Surgery (Trapezius Resection): One potential option is surgery to reduce the trapezius muscles, which can be overdeveloped from sports or weight training. This surgery involves reducing the size of the trapezius muscles, leading to a more slender neck and less bulk in the shoulder region, giving the appearance of a narrower upper body.

Liposuction/Body Contouring: In some cases, liposuction can be used in areas around the shoulders and upper arms to reduce the bulk created by fat or muscle mass. This isn't a structural solution for bone width, but it can help refine the silhouette.

Clavicle Shortening Surgery: This is a more extreme and rare option, where the clavicles (collarbones) are shortened to reduce shoulder width. However, this surgery is not commonly performed due to the potential risks and recovery involved. It is important to consult with a highly skilled surgeon if you are considering this option.

Non-Surgical Options:
Hormone Replacement Therapy (HRT): Estrogen and anti-androgens can reduce muscle mass over time, which may naturally lessen the appearance of broad shoulders by slimming the overall frame, especially if you have muscle mass from your athletic background.

Posture and Physique Training: Working with a personal trainer experienced in gender-affirming fitness can help develop a fitness routine that slims the upper body while focusing on lower-body training to create a more proportioned look.

Clothing and Styling: Strategic clothing choices, such as wearing tops with softer fabrics, avoiding shoulder pads, and focusing on pieces that emphasize the waist and hips, can also help balance the proportions of the shoulders.

Next Steps:
It’s important to consult with a board-certified plastic surgeon or a gender-affirming care specialist who can evaluate your situation and discuss the pros and cons of these options. A personalized approach to your needs is key to achieving the look you desire while maintaining your overall health and safety.

Camille Cash, MD · Answer

If the look that concerns you has to do with muscle mass then Botox may help to slim the appearance of muscles. However there is a limit to the number of units that can be used.  If the width that concerns you is due to your bone structure then Botox will have no impact on the desired look.  I encourage you to visit with an experienced injector to get a better understanding of what you could expect in terms of results.

Leonard Grossman, MD · Answer

The majority of the shoulder width is determined by the skeletal formation and proportions. In some individuals who work out very hard, the shoulders will become wider because of their increased muscle bulk. In a patient whose shoulders are very wide because of their skeletal structure, it is advisable to increase the hip width by natural means to create improved proportions. In an individual whose shoulders are broad because of the muscle bulk, Botox can be used gingerly to create a reduction. I hope this helps and good luck from Leonard Grossman MD, New York City, Plastic Surgery.

Is there a way to reduce the width of my shoulders other than Botox?

Answers (4)

Answer: Reducing shoulder width

Answer: Reducing shoulder width

Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.

Is there a way to reduce the width of my shoulders other than Botox?

Answers (4)

Answer: Reducing shoulder width

Answer: Reducing shoulder width

Browse related questions

Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.