Shoulder Aesthetics: A Novel Synergy of Hyaluronic Acid Fillers and Neuromodulators

Aesthetic Plast Surg. 2025 Jan 22. doi: 10.1007/s00266-025-04701-6. Online ahead of print.

Abstract

The pursuit of aesthetically pleasing shoulder contours, particularly those characterised by a sharp, angular definition, has gained significant traction in Southeast Asia. Traditionally, neuromodulators have been used to achieve these results by inducing muscle atrophy, particularly in the trapezius muscles. However, this approach can carry potential risks, such as compromised muscle function and spinal instability. In response to these concerns, this article proposes a novel technique that combines the use of hyaluronic acid (HA) fillers with neuromodulators to achieve the desired shoulder contour. HA fillers, well established in facial aesthetics, offer the benefits of structural enhancement and long-term collagen stimulation. This combination technique aims to provide a more stable and natural-looking result by enhancing the underlying bone structure while selectively using neuromodulators to refine the shoulder profile. A clinical case study of a 32-year-old woman is presented, wherein 15cc of HA filler was injected into each shoulder to achieve a pronounced 90-degree contour, complemented by targeted neuromodulator injections in the deltoid muscles. The patient expressed high satisfaction with the outcome, noting the alignment with her aesthetic goals. This innovative approach has the potential to redefine shoulder contouring practices, offering patients a safer and more effective alternative to neuromodulators alone. Further research and clinical validation are necessary to fully establish the efficacy and safety of this technique.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Aesthetic medicine; Body sculpting; Hyaluronic acid; Neuromodulators; Shoulder contouring.

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