Bone Cement of Custom Skull Implant for Occipital Asymmetry?

Q: Dr. Eppley, I spoke with a surgeon who told me this:

“Bone cement cannot be inserted on the sides of the head because there are important muscles named Temporalis which cannot be separated from the bone. 

So, the asymmetry of the occiput can be improved to some degree, but you should consider that there is the limit of correction or asymmetry, especially on the sides of the head and the perfect symmetry cannot be achieved by any kind of surgery. 

The lowest margin for bone cement insertion is situated on the occiput as a parallel line as eyeball level. The neck muscles are attached on the below this line so bone cement cannot be inserted on this portion.”

This made me concerned, since part of my affected area is located on the left side just above the ear. I understand that this is where the temporalis muscle is located? 

What is your opinion on this, and does it also apply to custom made implants?

Also, do you have any before and after pictures of similar cases that you could show me?

A: What you have been told is not completely accurate in terms of the temporal muscle and its release to place bone cement. I have done that many times. What is accurate is that the low end of the occipital bone sits at the same horizontal level of the upper ear…higher than most people realize.

But when it comes to custom implants the muscle on the side of the head is irrelevant as it is placed over the muscle. Another reason for why a custom implant is far superior to the use of bone cements.

To learn more about custom skull implants and their use in plagiocephaly and all forms of occipital asymmetry I refer you to one of my websites,  and search under such terms as Custom Skull Implants,, Occipital Asymmetry, and Plagiocephaly. You will find dozens of case examples which so illustrate that good head shape symmetry can be achieved.

Dr. Barry Eppley

Indianapolis, Indiana