Indianapolis Skull Reshaping Provider
Dr. Barry Eppley

The human skull has an oblong shape that is longer from front to back than it is wide. While there are subtle variations in its oblong shape amongst age, gender and race, a smooth surface with gentle curves is considered desirable. With the exception of the forehead, most of the skull's shape is hidden by hair and not cosmetically significant. However, in balding men and in those with short hair and shaved heads, the shape of the skull can become a potential cosmetic concern.

Cosmetic skull abnormalities generally fall into three concerns; high spots or ridges, depressions or flat spots and bumps or lumps. Skull lumps can be small areas that are too high or be actual bony tumors known as osteomas. Flat spots usually occur either in the occipital or back of the head and in frontal forehead asymmetries. Flatness of the back of the head is one of the most common cosmetic skull concerns and is the result of infantile head positioning. High spots and ridges can either be a prominent sagittal ridge down the middle of the skull or from bulging on the sides of the head in the temporal or parietal regions.

The traditional concept of skull reshaping is that of infant craniofacial surgery, removing and reshaping the thin bone flaps that exist at that time around the age of two years or younger. Infant skulls can also be shaped non-surgically with helmet therapies. But when the skull becomes thicker with age, it is no longer possible to use traditional craniofacial surgery to improve its shape.

Cosmetic skull reshaping can either reduce high spots or build out low or depressed bony contours. In most cases, augmentation creates a greater skull effect than bony reduction. This is because reduction can only reduce the outer table of the skull, generally around 5mms to 7mms or less. The amount of skull augmentation that can be achieved is limited by how much the scalp can stretch, which can reach up to 15mms in a single surgery.

While reducing high spots or some bony thickness of the skull is done mainly by rotary instruments (burring), skull augmentation uses a variety of synthetic materials. These include acrylic (PMMA), hydroxyapatite (HA), Kryptonite and preformed implants. Each of these has differing physical properties, such as handling and cost, which gives each of them certain advantages and disadvantages. No single cranioplasty material is perfect.

One of the most critical decisions when considering cosmetic skull reshaping is the surgical access in which to do it. This means an incision and a resultant scar will be created. In a cosmetic operation, the size and location of the scalp scar must be strongly considered. While some skull reshaping can be done through limited incisions or an endoscopic approach, many of the operations need longer incisions. The location and length of the scalp scar can be the key issue in determining whether cosmetic skull reshaping should be done.

To view a photo gallery of skull reshaping, please visit our skull reshaping surgery results page.

As a premier Indianapolis plastic surgery provider, Dr. Eppley performs a range of intricate cosmetic and reconstructive procedures, including scar revision and migraine surgery. He is also a top-notch Indianapolis rhinoplasty and neck contouring Indianapolis surgeon.