Abstract

Objectives: The primary objective of this presentation is to introduce a novel, minimally invasive technique for shoulder augmentation using micronized acellular dermal matrix (ADM) injections. We aim to evaluate the clinical efficacy, aesthetic outcomes, and safety profile of this procedure in refining the shoulder contour. Furthermore, by analyzing our clinical experiences and patient satisfaction, we seek to propose a standardized injection protocol and establish micronized ADM as a safe, effective modality for body contouring. Introduction: Interest in shoulder aesthetics has increased, particularly in East Asia, where a well-defined “right-angled shoulder” is regarded as an important component of an attractive upper body contour. The aesthetic appearance of the shoulder is largely determined by the angle formed between the cervical region and the lateral endpoint of the shoulder, typically located between the acromioclavicular (AC) joint and the lateral border of the proximal humerus. We define this parameter as the cervicoacromiohumeral (CAH) angle. Patients with a drooping acromion, trapezius hypertrophy, congenitally narrow s Materials / method: Acellular dermal matrix (ADM) is derived from cadaveric human dermis harvested from the dorsal trunk and processed through decellularization and sterilization to preserve the extracellular matrix scaffold. Injectable ADM with a particle size of approximately 500 μm was hydrated and used for shoulder volumization. In selected cases, it was combined with a high–G′ hyaluronic acid filler. Clinical outcomes were evaluated using standardized photographic analysis obtained preoperatively and at 1 week, 1 month, and 3 months post-procedure. Results: Serial photographic analysis demonstrated effective volumetric enhancement with improvement in shoulder contour and the cervicoacromiohumeral angle. The augmented volume and contour were well maintained throughout the 1-week, 1-month, and 3-month follow-up periods. No major complications, such as infection, necrosis, or severe inflammatory reaction, were observed. Conclusion: Injectable micronized ADM offers a structurally superior alternative for shoulder contouring, successfully creating the desired "right-angled shoulder" silhouette. By directly enhancing the CAH angle via a regenerative biologic scaffold, it delivers stable, natural volume with an excellent safety profile, addressing the limitations of traditional methods. This novel protocol establishes a new paradigm in upper body contouring, though long-term follow-up remains essential to further refine injection parameters and synergistic therapies.