Q: Dr. Eppley, I am giving serious consideration to getting cosmetic surgery to reshape my skull. I have an compressed area on the top right/middle section of my head near or along the coronal suture. The distorted area is roughly about 2 in by 3 in. It hasn’t been much concern for me until now that I am losing my hair. I found your page and now have hope that I won’t have to feel embarrassed every time I take off my hat for the rest of my life. My ideal plan is to have a one time low maintenance fix. I saw some of the work on your websiteand it seems very good and I think that you might be able to help me. I have attached a few photos from a couple different angles so you can see the indented area. Ideally, I am looking to simply smooth it out and make my head symmetrical without a dent or a bump.. However I’m not all to sure on the technicalities of the procedure or if it’s as simple as I’m hoping. I would appreciate your honest opinion as to whether the risk of the surgery might cause more off looking results, like a bulging area or something? I’m more than sure you a very busy person but all the information you can offer me would be appreciated. Having this surgery is a huge, potentially life changing decision. Even more so considering it is on my head and I will have to display, see, and live with the outcome. Let me know what you think.
A: Thank you for sending your pictures. I can see clearly the indentation across the top of your skull. The best and only way to treat this would be with an injectable cranioplasty approach. An open approach would leave a scar that I would not consider an acceptable trade-off. The injectable or minimal incision approach would use two very small incisions (about 1/2 to 3/4 of an inch) on both ends of the indentation. Through these, the material (Kryptonite) can be injected and molded. These incisions would heal up and be virtually undetectable later. This is a fairly simple procedure to go through with minimal pain and swelling afterwards. The only caveat to the simplicity of this approach is how even and smooth the augmentation would be. Since it is a blind procedure, all material molding is done from the outside by hand by pushing on the scalp as it sets up. As you have mentioned, it would also be important to not place too much material so the area does not become a ridge instead of an indentation. That is the artistry of the procedure. A good question is what is the likelihood of having a contour deformity that may need a secondary touch-up or rasping? In my experience so far, it has been about 50%.
Dr. Barry Eppley