Can My Protruding Occipital Bone Be Reduced?

Q: Dr. Eppley, I’m 24 years old and I have scaphocephaly that I would very much like to have corrected. Frontal bossing is apparent, and I also display temporal hollowing, as well as depressions along a prominent saggital ridge (as long as I have hair on my head, these features are not a significant concern for me). What is a significant concern for me — something that I would sacrifice a lot for in the hopes of even a modest correction in appearance — would be the protruding occipital bone. In my case, the premature fusion of the saggital suture caused the occipital bone to form something of a pointed cap, which extends from the base to the top of the skull; as such,  the posterior fontanel is located high on the skull, and from a top down view, it mirrors the anterior fontanel. Are there procedures available to address this? Perhaps the occipital bone could be reshaped (shaved?), or would it be possible to perform a craniectomy in order to correct the appearance with a prosthetic? Thank you very much for your time, Dr.

A: The protruding occipital and posterior sagittal skull areas could be modified by burring reduction (shaving) not a craniectomy. Craniectomies are not going to be performed in adults for cosmetic concerns. But significant skull burring and reshaping often can be accomplished. How much reduction could be obtained would ultimately be determined before surgery by a few simple plain x-rays. But it is likely that the protruding occipital bone, particularly in the midline, is fairly thick and thus capable of being significantly reduced.
Dr. Barry Eppley
Indianapolis, Indiana