Hi everyone,
My name is Yuna and this is my first post on Susan's! I recently started MtF HRT (11/25), and I want to thank you all for building this wonderful community. I know I probably have posted in the wrong section, but I new here and couldn't find one that suits this topic. If you are a moderator please help me relocate this thread!
At any rate, I have always been dysphoric with my broad shoulders. I know many ciswomen have the same issue but I think mine are especially prominent even for a ciswoman with broad shoulders. I am already quite skinny to start with (5'8'' & 116 lbs) so I don't expect the muscle atrophy to help much with this issue... I heard that most western surgeons tend to avoid shoulder cosmetic surgery because it is too risky and invasive. I personally think no matter how feminine my face will look after HRT and FFS, my broad shoulders will almost immediately give away my being transgender.
After scouring the internet and failing to find a solution in the US/Canada, I came across the website of a Japanese surgeon, Dr. Kimura, who offers clavicle shortening surgery specifically for treating gender dysphoria. They seem to be very open with the cost of their services, and from their listing clavicle shortening surgery costs ￥1,030,000 JPY (around $8,600 USD). The pictures looked promising, and from what I read on the website with my limited Japanese, Dr. Kimura is extremely passionate about cosmetic surgery and experienced with what he does.
Pre/Post op pics:
<Link removed by moderator>
Cost of various surgeries offered:
http://www.dr-kimura.com/price/
The website says they offer consultation in Japanese and Chinese, but it doesn't mention English. Still I think with some effort we English speakers should also be able to work with Dr. Kimura. Anyways, I hope some of you might find this helpful.
Yuna
Have you considered the phsysical aspect of this surgery instead of the cosmetic? Having such a surgery is without any doubt making your arms weaker and subject to random pain all your life.
You would be changing the way your body moves. It is totally different from a gender confirmation surgery where they reshape, and move malleable parts of the body. I consider SRS/GRS a procedure that does not affect the overall movements of the body.
You should question what your understanding of the skeletal structure is, and then think about how your shoulders work both before and after surgery.
There is a reason US, and Canadian surgeons do not perform this surgery.
Google Chrome translates the Japanese to quite good English.
archlord and ARIA FAYE, thank you for the advice! I can't agree more with both of you. It is definitely a highly risky procedure, and there is very limited information online. At the same time my shoulder width is something I am just so desperate to fix. I will definitely do more research on the side effects before making a decision in the future. Also I just want to make it clear that I do not recommend this procedure unless you absolutely cannot live with your broad shoulders. I just brought it up because I think it is new information that is worth sharing.
My advice is "don't even think about it." You can always find some quack somewhere that will do anything for money, but you are talking about tampering with a vital portion of your skeleton that you use every single day. Trying to alter this area could throw off your whole body, cause weakness and chronic pain, and look "weird" to boot. I used to worry about my somewhat broad shoulders, too, but not I never even think about it and not one person has ever said it outed me. Sometimes you just have to accept that we have things about ourselves that we don't like but can't, or shouldn't, change.
Something looks off with those before and after pics. Like, she's pushing her shoulders forward in the first (and leaning forward, it appears, based on the shadow behind her), and holding them back in the second, with her arms rotated differently, to make the result look more dramatic.
Furthermore, it doesn't change the breadth of her ribcage, which is still out of proportion. And there will be significant scars on her shoulders, based on the where the bandages are.
Your arms are attached to the scapula (shoulderblades). If you shortened the clavicle, it would pull your shoulders forward and make you permanently hunched over.
Nothing in my life has ever been as painful as a broken clavicle and the surgical repair went really well but was certainly not an easy recovery.
I can't even vaguely imagine intentionally fracturing/shortening, YMMV of course. As much as I hate that women are attracted to my shoulders, changing the structure that radically is something I wouldn't consider. It's already a bad design and further compromising that isn't acceptable. That said i rely on my body for work and most of my recreation so your evaluation could be different.
That said, Japan is a hugely appearance - conscious society as well as not very open to non binary gender. So adopting radical surgeries seems like something that would happen there.
Yuna! Please listen to this. Clavicle connects the acromion process of your scapula to your sternum.
Now, although its a very small bone, it has a very important function; it keeps your upper limb away from the chest. Your clavicle is the reason, you can freely move your shoulder.
Clavicle rotates when you abduct your upper limb at the shoulder joint. Watch some youtube videos about the anatomy and mechanics of the clavicle for better understanding.
Tampering with the clavicle is like tampering with the free movement of your upper limbs. Clavicle is also responsible for supporting your scapula and your limb.
Believe me, I'm a med student. I know, one shouldn't go around messing with the clavicle.
It will change your posture, it will change the way you walk, it will restrict the mobility of the shoulder joint.
Also, this is not a doctor's opinion. I'm just a student.
My wife broke her right clavicle in an auto accident while visiting family in the Philippines. After flying her back here I took her to the best orthopedic surgeon I could find. After examining her he told us that it was actually better to leave her arm in a sling and let the clavicle heal on its own than it was to open her up and pin the bone back together.
Yes the bone did heal crooked, my wife has a little dent in her shoulder and she gets pains in that area whenever it rains, but she also has full mobility and use of her right arm -- other than some pains here and there during heavy lifting.
Just my opinion, but I think that is not an area of the body that is to be messed with.
Besides, Caitlyn Jenner has broad shoulders, no one notices and she is beautiful.
Welcome to Susan's Place. I to believe that the surgery is rather invasive and can change the mobility of the arms. I have broad shoulder and a big rib cage and have chosen instead to wear lose fitting tops with sleeves in order to obscure the size of my shoulders. On the other hand, I have been on HRT long enough that the padding on my hips somewhat balances out the shoulders so I am able to get away with swimwear if I am so incline. I have found that other features are more likely to expose you in public than shoulders so it's would be best to concentrate on those issues.
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Have you considered that your low weight may contribute to your shoulder looking wide? To me it sounds like you are a rather skinny girl being 5"8' and only 116lb. And proportions are very important when viewing certain features. This sounded very insensitive with word as skinny, I do not mean to be cruel and don't want ´to body shame in any way. I just wanted to give a new perspective. Hope it all workout :)
I cannot comment on the clavicle shortening procedure, but did look up some information on the establishment as a whole out of curiosity.
The Yasumi clinic reviews I found appear mostly positive. It was established in 1964, and Dr. Kimura joined it in 1994. He is a member of the Jujin and Omori plastic surgery associations, at which he appears to present annually. As for his qualifications as a physician, he would appear to be certified as an orthopaedic and plastic surgeon and to also hold a license in anesthesiology.
From the information on the website itself, besides aesthetic procedures the clinic also offers sex reassignment and other gender-related surgery. Where SRS is concerned, the clinic appears to use the Wada method, and the web site claims that the constructed female genitalia are self-lubricating.
I was going to post a new topic on this after learning this surgery exists on >-bleeped-< but I think I'd rather just revive this thread.
Has anyone in this community done this surgery yet? Also to all the naysayers...we all agree that the recovery would be immense, but this type of surgery is commonly done for clavicle fractures and there are people in this world who actually function fine without clavicles (look up Cleidocranial dysostosis). There are also many athletes who function just fine in sports after open reduction of the clavicle. It really just sounds to me like a controlled fracture as opposed to one due to trauma. Plus--someone has to be the pioneer. I wonder if everyone will say that about uterine transplants when we finally find a doctor who is willing to perform them in amab transwomen.
Quote from: JessieBirdie on October 23, 2017, 09:51:05 AM
I was going to post a new topic on this after learning this surgery exists on >-bleeped-< but I think I'd rather just revive this thread.
Has anyone in this community done this surgery yet? Also to all the naysayers...we all agree that the recovery would be immense, but this type of surgery is commonly done for clavicle fractures and there are people in this world who actually function fine without clavicles (look up Cleidocranial dysostosis). There are also many athletes who function just fine in sports after open reduction of the clavicle. It really just sounds to me like a controlled fracture as opposed to one due to trauma. Plus--someone has to be the pioneer. I wonder if everyone will say that about uterine transplants when we finally find a doctor who is willing to perform them in amab transwomen.
Not being a risky procedure for the sake of vanity, uterine transplants will probably have a reasonable take up. Given this will also be done primarily on cis women with fertility issues, again I can see a good take up.
Given the other issues that can occur with Cleidocranial dysostosis, I'm not sure I'd describe that as "function fine". I suspect you have a somewhat incorrect idea of what an open reduction is - moving the bones back in to the correct position to enable proper healing.
Clavicle shortening is not common and certainly isn't done as part of a repair. A repair should end with a result that is as equal to the original as possible.
Ignoring all the above, I've got a feeling that many Ethics Committee's would not allow this surgery.. "First do no harm" and all that stuff..
Quote from: kelly_aus on October 23, 2017, 03:56:49 PM
Not being a risky procedure for the sake of vanity, uterine transplants will probably have a reasonable take up. Given this will also be done primarily on cis women with fertility issues, again I can see a good take up.
Given the other issues that can occur with Cleidocranial dysostosis, I'm not sure I'd describe that as "function fine". I suspect you have a somewhat incorrect idea of what an open reduction is - moving the bones back in to the correct position to enable proper healing.
Clavicle shortening is not common and certainly isn't done as part of a repair. A repair should end with a result that is as equal to the original as possible.
Ignoring all the above, I've got a feeling that many Ethics Committee's would not allow this surgery.. "First do no harm" and all that stuff..
...you got me, I'm not a doctor. I think I meant resection--tbh. Point is, this is something that is still done regularly (shortening of clavicle due to an injury).
Also by that definition I think we could say the same thing about FFS and breast augmentation. The whole matter of what is "do no harm" is subjective. Further...the worldwide "ethics committee" on uterine transplants by and large currently has guidelines about only working with ciswomen afaik (and it has been done with ciswomen). View the uterine transplant article on Wikipedia and the matter of "Montreal Guidelines". Find me a doctor that's willing to try this on a trans person considering...(yes I will admit, uterine transplants do have additional ethical issues due to the introduction of a second life in the picture, as opposed to just one person, but still).
Also can you show me shoulder specific complications (stuff not related to loss of other bones related to the condition) of Cleidocranial dysostosis?
Quote from: JessieBirdie on October 23, 2017, 09:11:42 PM
...you got me, I'm not a doctor. I think I meant resection--tbh. Point is, this is something that is still done regularly (shortening of clavicle due to an injury).
A clavicular reduction is done as a last resort, when other options are not available.
QuoteAlso by that definition I think we could say the same thing about FFS and breast augmentation. The whole matter of what is "do no harm" is subjective. Further...the worldwide "ethics committee" on uterine transplants by and large currently has guidelines about only working with ciswomen afaik (and it has been done with ciswomen). View the uterine transplant article on Wikipedia and the matter of "Montreal Guidelines". Find me a doctor that's willing to try this on a trans person considering...(yes I will admit, uterine transplants do have additional ethical issues due to the introduction of a second life in the picture, as opposed to just one person, but still).
When the procedure is more mainstream and better understood, I don't think you'd have any trouble finding a surgeon to perform a uterine transplant on a trans woman - I also suspect there would be plenty of volunteer patients. Medical Ethics change, often as a result of a doctor/surgeon's pushing their facilities Ethics Committee. SRS was once considered unethical. From an ethics perspective, I have no issues with BA, it has little or no effect on overall function and is easily reversible. FFS does include some procedures with which I do have issues, but Informed Consent comes in to play there.
QuoteAlso can you show me shoulder specific complications (stuff not related to loss of other bones related to the condition) of Cleidocranial dysostosis?
Scoliosis can and does effect shoulder function.. And, IIRC, there can be some impact on the brachial plexus..
Suggesting that clavicular reduction is fine because people with cleidocranial dysostosis can function without a clavicle is quite disingenuous, as most wont bother to read what cleidocranial dysostosis is and will be unaware of the other issues it comes with, not to mention the hunched posture..
You say all these things but seriously, every other day lately it feels like I need something like this done still. I had two occasions literally yesterday where I swear it had to be my body shape that got me misgendered. Only my face is my saving grace especially since my ffs.
A: I was at gaymerx east, wearing an oculus rift playing some VR. I was pretty sure I heard the staff using he pronouns on me after some technical issues until I took the rift off. They clearly weren't looking at my name tag either.
B: Walking back home on dark streets in NYC. I walk past a homeless person, I'm initially asked, "Do you have any change sir?" until I get closer, he then switches and says sorry ma'am. Clearly it's my outline that is an issue.
I feel like my only recourse quite frankly is to wear skirts/dresses all the time and to be frank that is just not me. I need to fix my body shape, and I don't know how to other than something like this. I'm post op, barely 26, been on hrt for 8 years, 5'10.5", in decent enough shape (I kickbox against a bag like 2-3 times a week and do not weight train), and my shoulders are quite frankly huge. It bothers me to no end--its not like I have an oversized ribcage (38 inches...I can still buy bras retail). It is legit my shoulders and I know it is.
To be quite frank too...I was also looking at my mom and recalled her type v shoulder separation about a year ago from a bicycle accident, she had it operated upon at NYU langone. The x-rays clearly show a clavicle jutting upwards so clearly the separated part was the clavicle. She has one shoulder that is clearly bigger than the other due to it and definitely had a difficult recovery. However, 6 months after, I haven't heard her complain about anything and her operated upon shoulder is clear smaller than the other one. She does yoga, biking, whatever now and can lift things from up high just fine, and she's in her late 50s.
Idk...I'm just leaning more and more towards getting this done lately. I've gone through GRS (with complications), I've gone through FFS, both were beyond worth it but super hard. Thus, I really want to hear honest opinions about what it's like with this guy or if there are other doctors willing to do it. I'm not interesting in hearing, "don''t do it". Please people...the only thing that's stopping me right now is that I really just want to start really living my life as opposed to just throwing money/saving for surgeries like I have since I left college 5 years ago. Physical pain is nothing if it solves the emotional pain. Le sigh...
I think rather than clavical surgery, I would go with hip/butt implants to balance out the shape more. Way less risky, IMHO.
I have been in touch with Dr. Kimura in the last couple of months and have been planning for the clavicle surgery with him. Risks and complications aside he said the most important thing for international patients is that the patient must be able to live in tokyo for 6-12 months. He said it has to be inside tokyo, as he wants to be able to see you immediately regardless of business hours if complications occur. He has rejected many domestic patients in the past because they lived next to Tokyo or farther.
He said the reason why the patient needs to stay in Japan for that long is that depending on the individual, long-term complications such as inadequate bone healing is possible, and in case any revision surgeries would be needed he would not risk letting any other doctor interfere until you are fully healed.
In addition the procedure must be split into 2 phases, left clavicle and right, because daily activities would be impossible with both clavicles operated on simultaneously.
As to the amount of shortening possible he said based on clinical studies of this procedure in Japan, a reduction of 10% in length produces no side effects to the movement of the arm after healing. Movement is partially impaired when reduced more than 15%, and is generally not recommended. He said the maximum he would do is 10%, and will not go beyond that for any reason. He said some of his patients were happy that they were able to wear women's L instead of 3L after surgery.
Also a second surgery would be needed 2 years after the procedure to take out the screws and stuff that lock the fractures clavicles in place as they would no longer be needed once the healing process is done.
I talked to him on the phone and he was quite a talkative person. He gave lots of helpful information to me and after all I think it would be something I would like to pursue. He said the longest it took his patient to fully heal was 12 months, 6 months left and 6 right. It definitely is a huge commitment but I still think it is worth trying as I believe there definitely are people who have beautiful faces but cannot pass due to very broad shoulders. I cannot go to Japan right now as I have my FFS scheduled with Dr. Spiegel in March, but I am hoping to go to Yeson for VFS in April and after which going to Dr. Kimura in May if everything goes well.
Please let me know if you have any questions, I'll try to answer them as best as I can. I can read Japanese articles and do more research for you if you are interested.
Best,
Yuna
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Quote from: Daisy Jane on November 06, 2017, 11:21:33 AM
I think rather than clavical surgery, I would go with hip/butt implants to balance out the shape more. Way less risky, IMHO.
What a great idea! Lateral thinking. I think my shoulders are too wide, although balanced somewhat by my head being too big (physically, too - strange, as I sometimes wear a fedora that belonged to a Kenyan schoolgirl). I used to be embarrassed by my big bum, but hip implants might be a good idea if I win the lottery (unlkely, as I don't play it any more).
I don't think your last post was a positive support, Mona.. I was aware it was a complex procedure, but the requirement of living so close by, for so long, due to complications is a large red flag to most.
I'm sorry you don't see any other options to this. I'm sorry you are so convinced it's needed.
Please do not see my previous post as a support for the procedure. This procedure is most likely too risky, unsuitable, and inaccessible by most, but I think it doesn't hurt to document it here. I think it is always better to give ample information for people to make informed decisions than forcing them to blindly go to third world countries to get procedures without any knowledge of risks and side effects. It is exactly because of how invasive and risky of a procedure it is that made me decide to document it here.
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These posts makes me sad as I realize how much we have to go through for things that others take for granted. I wish you the best yuna and hope that you are complication free and happy with the end results.
Quote from: Justarandomname on November 07, 2017, 07:10:44 AM
These posts makes me sad as I realize how much we have to go through for things that others take for granted. I wish you the best yuna and hope that you are complication free and happy with the end results.
I feel the same way. :(
Anyone know what happened to Yuna? Has she had her surgery yet? Is she okay? How does she feel about the results?
Also, I feel you, JessieBirdie. No opinion on whether or not such a procedure is a good idea. But I understand where you're at. I'm at a similar place. To get rid of the misgenders I'd really need to dress full on femme, and it just isn't me. I'm a butchy woman, and if transition is about nothing it's about being able to be yourself.
all the best,
joanne
How did you get in touch with him if you didn't speak Japanese?? I've been trying to get a hold of him to get the surgery done. Any tips?
And have you done the surgery ???
Hi all,
Sorry for the lack of update. I just had my FFS done with Dr. Spiegel and got a reimbursement from BCBS of MA. I am scheduled to have VFS with Yeson in late July instead of April that I originally planned, because I had a trachea shave done with Dr. Spiegel, and Dr. Kim at Yeson suggested that I wait at least 4 months after trachea shave before I get VFS. I am getting FFS and VFS done first because I am trying to postpone the final decision on the clavicle surgery as much as possible, so that I have enough time to really think about it and gather enough information. I do plan to go to Japan to see him in person for a consultation though after I recover from VFS. Meanwhile there is not much I can do to accelerate the process, but if I have anything new I will definitely let you know.
Also even though I speak English, I am more comfortable with Korean, Japanese, and Chinese, as English is my fourth language. I assure you that there was no translation involved or any sort of misinterpretation during my communication with Dr. Kimura. I might post the email responses I received from Dr. Kimura along with the translation if I can get his permission to do so.
He also added that he always tells patients who are not married that he strongly recommends against getting the surgery because their future partners will inevitably see the scars and have questions. Basically he is concerned that the surgery would make dating more difficult, and he thinks having an accepting spouse who is ok with the scarring will be easier for the patient in the long run.
He also mentioned the surgery will probably impose a limitation on personal clothing choices especially when it comes to clothing that exposes the shoulder area. He said he would feel bad to take away people's freedom to dress the way they like, and that he would rather operate on patients who are both more mentally and physically mature (maybe because he thinks typically people would prefer to dress more conservatively as they age?)
Please feel free to let me know if you have any more questions.
Best,
Yuna
Oh my.. is the scarring really that bad/noticable? Well if you've processed that and still want the surgery than I think it'll be fine for you. At some point srs was seen as invasive and still kinda is. It's just in an area a lot less people tend to see.
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Quote from: yuna on April 26, 2018, 10:13:40 PM
He also added that he always tells patients who are not married that he strongly recommends against getting the surgery because their future partners will inevitably see the scars and have questions. Basically he is concerned that the surgery would make dating more difficult, and he thinks having an accepting spouse who is ok with the scarring will be easier for the patient in the long run.
Doctors sometime make me want to facepalm. Your quote makes me think of something a certain trans blogger I personally know once wrote about a certain GRS surgeon who doesn't exactly have a good rep.
https://medium.com/@lifeafterdawn/the-surgeon-who-told-me-to-switch-my-sexual-orientation-76814ad5e37c
""Even if I do my best, you'll never be able to please a man," Doctor Dip
>-bleeped-< told me. As if pleasing a man was my ultimate goal."
Referring to not getting good depth or something like that. Le sigh, I just hope this guy's surgical technique and care is better than his bedside manner--which hopefully is just a byproduct of Japanese culture (which is known to be slightly anti-feminist/misogynistic).
Anyway, that seems pretty intense all the same. I'd only wonder if it's all worth it in the end, I'd like to see results and talk to people who have gone through it.
There's a YouTube video just posted about this surgery on a transwomen from Dr Leif Rodgers in Beverly Hills, USA.
I won't post the link since its got surgery footage in it, but it should be easy to find.
"Shoulder Width Reduction Surgery Before and After" by LeifRogersMD, published Aug 23 2018.
If you search you can also find a post on another site by the women who had the surgery.