Q: Dr. Eppley, I am a young man and I am embarrassed of the shape of my head. My head circumference is about 58 cm which seems to be only about 1-2 cm more than the average but the shape is abnormal- as it gets wider above the ears and temples on both sides. What is very surprising when I clench my jaw both sides of the head gets wider (about 0.5 cm) each side, and when I widely open my mouth both sides of the head get thinner and head looks almost normal. Would you be so kind to answer my questions. Is there any possibility to reshape my head on both sides. If yes what is the potential risk of such surgery- is there any chance to damage my brain, nerves, veins etc and is such surgery a big risk for my health and life? Does the surgery may affect in a bad way circulation of the blood in my head which my cause for example hair loss (it is extremely important for me to protect my hair because that is the only way I can mask shape of the head). What is the recovery time? I train bodybuilding and boxing especially the second one is obviously extremely contact sport- will I be able to continue my two passions and how long after surgery will I be able to come back to training?
A: What you are describing perfectly are thick temporalis muscles which is making a major contribution to the width that you are seeing above your ears and into the temple region. This is evidenced by the widening effect that occurs when you clench your teeth together (temporalis bulging) and why it gets thinner when you open your mouth. (stretches and thins the temporalis muscle) This dynamic head width changes indicate that a temporal reduction (temporalis muscle shortening/relocation procedure) would be very effective. This results in a 5 to 7mm change per side (1.0 to 1.5 cms transversely combined) when these muscles are shortened. In addition a small amount of bone burring can be done at the same time. Not that you know the correct procedure, the answer to your questions are as follows:
1) There is no risk to your brain or any major blood vessels or nerves.
2) There is no risk to your general health. This is an aesthetic operation.
3) This surgery does not affect the circulation to your scalp or head.
4) There is no risk of any hair loss.
5) The recovery is fairly quick, just some swelling on the sides of the head that looks pretty normal in a wee. There are no restrictions after surgery.
6) You could return to contact sports within two weeks after surgery.
7) I will have my assistant Camille pass along the cost of the surgery to you later today.
The biggest issue in performing temporalis reduction surgery is that fine line incisions are needed on the side of your head to perform it. These incisions do not cause any hair loss and I do not shave the incision line to perform them.
Dr. Barry Eppley