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

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.

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.

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.