Occipital Augmentation

Q: Dr. Eppley, I’m a 27-yr old female. I have been thinking about having an occipital augmentation procedure done to correct for the flatness and asymmetry at the back of my head, due to bad sleeping position from when I was an infant.

Currently I have two questions regarding the procedure. I will be very grateful if you can give me some answers:

1) I’m hoping to achieve notable increase in the projection of my upper occipital region. I know this will depend on the laxity of my scalp. According to your experience, can you tell me that, for an average person in my age range, how much increase in projection (in cm) is realistically achievable? I’m thinking about using implant.

2) Will screws be needed for the fixation of the implant?

3) Is this performed under general anesthesia? Or local?

4) Is it possible to achieve notable increase in projection with bone cements?

5) What would the cost be for a typical occipital augmentation procedure?

6) After the procedure is already performed, how many days will it take for me to be able to go back to work?

Thank you in advance.

A:Thank you for your occipital augmentation inquiry. In answer to your questions:

1) Normal scalp laxity will permit a 10 to 15mm increase in central projection. More than that requires a first stage tissue expansion.

2) I always use two microscrews for early implant stability.

3) General anesthesia is required for the surgery.

4) Bone cements can not create the same outward push as an implant for a wide variety of reasons.

5) My assistant will pass along the cost of the surgery to you later today.

6) Most patients should be able to return to work in 7 to 10 days after the surgery.

Dr. Barry Eppley
Indianapolis, Indiana