Q: Dr. Eppley, I am interested in skull reshaping surgery. I am a 35 year old female who is concerned about head size and shape. My head is wide and big overall. Especially, the top and the sides of parietal bone are bulged so that it is really difficult to find hats to wear. I hope to reduce the top and side portions of my skull as much as possible. Having the surgery done is only way to get to rid of my life long distress. Is it possible for a patient who lives outside of the US to get this surgery done? The hardest part for me is to take a long absent from work so the time is my big concern. How many visits are required before and after the surgery? If I am sure to have the surgery, is it possible for me to visit you first time and get the surgery done in a week or so? I could possible use the weekend for before and after consultations. Another concern is that I need to visit and get through it by myself. Would that be okay?
I am sending you some pictures. Because of my thick hair, it might be hard to understand my head shape. But my hair is wet and pushed to my skull. I would not say my head is deformed. The head shape is like an apple. Both back sides of my head are sticking out. I also wish to reduce the top portion of my head as well to make my head smaller overall. Especially, the back side of the parietal region.
Here are some specific questions…I am sure you get these questions all the time.
1) What are the risks of the head reshaping surgery?
2) How much swelling will be expected? Does my head get bigger than before until the swelling goes down?
3) What will happen to the excess skin? Is it possible to cut it off? Is there any sagging skin issue after?
4) For the top and the side skull reduction how long the incision will be?
I don’t know how much physical difference you can make. But even 5 to 7mm, I will be
Sorry to bother you with many questions. Looking forward to hearing from you.
A: It is very common in my practice to have patients come from all over the world so we are very familiar with this scenario. Far away patients usually come in a day or two before surgery, have the surgery, and return home in 3 to 4 days after this type of surgery. Most do come but themselves which is why they stay overnite in the facility after surgery. Any after surgery followup is done online by email so there is no reason to return for a specific follow-up appointment. It is usually just a one time visit for the combined consultation and surgery.
In regards to skull reshaping, specifically skull reduction, the answer to your question is as follows:
1) The only risk is that there will be an incision (scar) to do the surgery and the question of how much can be reduced. (i.e., can enough be done to make the surgery worthwhile) In that regard you have made a key statement in that if even 5 to 7mms was taken down that would be viewed as an improvement. By that measurement of success, then it would be worthwhile as that is what can be maximally taken down in most areas.
2) There would be some swelling and your head would initially be slightly bigger than when you started. But the swelling is not so significantly different that it makes your head look overly big.
3) There would be no sagging skin afterwards. The scalp skin will shrink down quickly to adapt to the smaller size.
4) To get the maximal reduction of all involved areas, an incision would be needed in the more traditional coronal style, meaning a longer incision from the top of the ear from wide to side. This gives maximal exposure to do the work for the best reduction possible. It is an incision that heals well with a very fine line scar in most cases.
Dr. Barry Eppley