Can Skull Reduction Be Done Past The Diploic Space?

Q: Dr. Eppley, I am interested in skull reshaping. In particular skull reduction on the top of my head, and maybe some implant on the back of my head.I do however have prior history of hairline lowering through an incision in the hairline, and a coronal incision from ear to ear, which has been opened twice.My question is if these prior surgeries would complicate the skull reshaping? Could results be seen at a later stage, and would swelling etc be more prolonged ?

Would it be possible to go beyond /into the diploic matter if the burring is done over two separate skull reduction procedures?

Also i would be interested in maybe some burring of the frontal bone, but am not sure if i feel okay with doing all of this in the same surgery. Could the frontal burring be done in a later stage, and through the coronal incision? Would this also effect a potential prior top of the head reduction?

A: In answer to your skull reduction questions:

1) The benefit of a pre-existing coronal scalp incision is that at least the scar location/tradeoff in male skull reshaping surgery has been decided. Its repeated use does not increase healing time or the amount of postoperative swelling and provides convenient access for whatever skull reshaping procedure is desired. In short it doesn’t complicate secondary skull reshaping surgery, it actually is of benefit.

The only question I have about the coronal scar is why was it done. This is not an incisional approach used for hairline lowering. And why was it opened twice?

2) Bone burring in the skull can not safely goes past the diploic space.

3) Whether one does bone burring on top and in front together or in two separate stages is a personal choice.

Dr. Barry Eppley

World-Renowned Plastic Surgeon