Can A Second Sagittal Ridge Reduction Go Deeper Than The First One?
Q: Dr. Eppley,There is something I would like to hear your option about. About 1 month ago I got a surgery for a saggital crest removal, like you did in many of your cases. The plastic surgeon removed about 1 mm of it and told me, there is no way to go deeper, because of the diploic space. In your cases you describe about 5-6 mm wich would have been more than enough for me. I think he was scared to burr deeper, he definitely haven’t got the experience in those cases as you.
Let’s say he is right and he was close to the diploic space, is there no way you can burr a little bit into it as well? (Maybe close it again with bone cement f.e.) Btw. No x ray scans were taken
I am looking forward to visit you, I was wondering, how do you reach the 5-6 mm ? A answer would mean a lot to me
A:I obviously can not speak to what was observed during your sagittal ridge reduction surgery or how thick your sagittal ridge actually is. What I can say is that based on my experience it would be unusual for a 1mm bone reduction to end up in the diploic space and there would be a need to stop there. Certainly if you don’t have a lot of experience in skull surgery and don’t have a preoperative CT scan to absolutely know the thickness of the bone I can see why a surgeon would stop short of a maximal reduction.
That being said don’t presume before having another procedure what the bone thickness is. Approach any further sagittal ridge reduction knowing what is both possible and safe. That is how I would do it.
Dr. Barry Eppley
World-Renowned Plastic Surgeon