How Can The Dent In The Back Of My Head Be Fixed?

Q: Dr. Eppley, I am looking to fill the dent in the back of my head to achieve a more normal, round head. My flat spot/indentation is very obvious and noticeable from certain angles. It is located in the back left side of my head, a bit higher and closer to the top of the head. The dent leads to another minor flat spot right where the head curves from the top to the back. What I would like is an injectable cranioplasty operation and suggestions if there are any better options. Also, what is the recovery process of the operation? Thank you very much and your feedback and insight is tremendously appreciated.

A: Injectable cranioplasty is a technique that I have developed to avoid any significant scalp scarring with limited build-ups of the skull. Small back of the head indentations/flatness are the most ideal areas. The concept is based on having a cranioplasty material that is liquid enough during its initial mixing that it can be injected and then sets in a reasonably short length of time there after. A small one inch is needed to lift the scalp tissues off of the bone and develop the desired recipient pocket. It is through this small incision that the material is injected. Once injected the material must be molded into shape from the outside through the scalp. While Kryptonite was initially the material I used, it is no longer available as the manufacturer has withdrawn it from the market. (the reason I do not know) I am now working with another calcium phosphate material, OsteoVation, which I actually like its handling properties better.

While the injectable cranioplasty approach certainly has its appeal, it is not without any downside. Its biggest drawback is that getting the material smooth is a blind procedure and rarely does it ever become perfectly even. The other issue with it is cost. These materials generally cost 2X to 3X more than conventional PMMA cranioplasty material which needs to be placed through an open incision. (about 9 cms) The guarantee of optimal smoothness shape requires an open cranioplasty approach.

Dr. Barry Eppley


Dr. Barry L. Eppley
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Board Certified Plastic Surgeon