Is Head Widening Best Done With An Implant Or Fat Injections?

Q: Dr. Eppley, I have a very narrow, dolichocephalic skull shape and I would like to increase the width of my head. According to the information on head widening provided on your website there are two options to achieve this:
1. Augmenting the posterior part of the temporalis muscle by injecting fat.
2. Placing an implant under the temporalis muscle above the ears.

I prefer option 1 since I would like to avoid implants. However, if the achievable results of fat injections are unsatisfactory I will gladly consider alternatives.

Thus I have the following questions:
1. By how many millimeters can the head be widened through fat injections to the posterior aspect of the temporalis muscle? Are 5mm per side achievable?

2. How much would the procedure cost if i) only the posterior part and ii) both the anterior and the posterior part of the temporalis were to be augmented?

3. How much does it cost to widen the head using semi-custom-made implants with a thickness of 5mm per implant?

4. Are there any other methods to increase the head without producing visible scars?

Thank you for your time.

A: The short answer to your question about head widening through posterior temporal augmentation is that only an implant is going to consistently work. The first issue with fat that you have to have enough to harvest, process and then inject. In a thin person, which it appears you are, that could be the rate limiting step right there. No matter what is injected only a fraction will survive and what survives most certainly is not likely to be symmetric.

The use of a semi-custom temporal widening implant is assured, can easily increase the side width by 5mms and is placed through an incision that is limited to the back of the ear. (thus being placed in a scarless fashion) Any consideration of fat injection use should be limited to the temporal hollowing located next to the eye area (anterior temporal augmentation) where a more posterior implant does not reach. There are very effective implants for that area as well but they require a more exposed vertical incision in the temporal scalp region.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry L. Eppley
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Board Certified Plastic Surgeon