Can I Use Hydroxyapatite For My Skull Augmentation?

Q: Dr. Eppley, I am interested in skull and face reshaping surgery. I’m not happy with my head being too wide and having a bump on my left side. My head is also flat at the back. Thus, I am interested in having temporal muscle reduction surgery ( bilateral ) and augmentation of the back of my head with hydroxyapatite. I would also like more masculine and prominent forehead bone and would like to have augmentation with hydroxyapatite there as well. I have read that Dr. Eppley recommends implants in many cases, but I’m more interested in hydroxyapatite. However, it would be good to know the difference in price between implants and hydroxyapatite in my case?

A: The combination of side of the head narrowing (temporal reduction) with back of the head augmentation is a good one to achieve the head shape change you are seeking. However the use of hydroxyapatite bone cement for any form skull augmentation would be the worst way to do it. Besides the large scalp scar that is needed to provide the working space for such bone cements it costs would easily be 2x to 3X that of custom skull implants and would only achieve 1/3 of the augmentation result. Everyone overlooks that such bone cements were only ever made to fill in skull defects and where never intended to be used for aesthetic onlay augmentations, thus their poor ability to do so. While their biology has understandable appeal their aesthetic effects do not remotely match it.

Dr. Barry Eppley

World-Renowned Plastic Surgeon