Can I Get Further Skull Width Reduction With Bone Burring?
A: Thank you for your inquiry and detailing your skull reshaping objectives. I have yet to see a patient who didn’t get adequate skull width reduction with muscle removal alone. But that issue aside the question of whether bone reduction will finally get you to the head width you desire depends on the surface area of the bone removal and how thick that bone is. The measured head circumference line (tour de tete) in your diagram is angled rather than purely horizontal (a line around the top of the ears) in which the temporal bone location is the fossa, the concave portion of the temporal bone. Thus bone reduction will not produce any effect in this area. Rather the convex portion of the temporal bone above the ears is its widest part in which bone reduction will be more effective.
That being said how thick this portion of the temporal bone is and whether you can make the type of skull width reduction you want would require a CT scan to make that assessment.