Can The Flat Back Of My Head Be Fixed?
Q: Dr. Eppley, I am a young man with a skull that is flat at the back. It has caused me a lot of grief as a teenager and to this day and I think it’s time I did something about it so I can stop being so extremely subconscious about it. I have attached pictures which show how flat the back of my head is when the hair is parted in such a way or id wet. The flatness is pretty much only isolated to the back of my head. At the very top of the head near the crown there is a noticeable ‘bump’ then the skull goes in a drastic decline. The forehead, and front sides of the head appear and feel normal/symmetrical it just the back which is causing the aesthetic issues for me.
From my research you appear to be the most qualified to do such an operation as you’ve had a great number of patients with the same issue as me therefore I would fully feel comfortable with you doing this procedure because of your extensive experience. This brings me to my next question, can you help me? From the pictures provided do you think you could give me the normal male skull I desire? There is nothing more I want than being able to shave my head really short. I understand there are different methods of operation some more intrusive than others. I am actually not concerned with the scars the operation will leave so long as it gives me the normal shape I have always desired, a skull that appears normal and wouldn’t get a second look from passers by because it’s normal. I would only want one operation to fix this issue and would like to avoid having to come back to do revisions to the operation. Now, having that in mind what type of procedure would you recommend for me?
A: Thank you for your inquiry and sending your pictures. I can clearly see that your degree of occipital flattening is significant. It is probably one of the more flat back of the head cases that I have seen. When it comes to correction, I think you have two options. First, using a standard open technique a cranioplasty can be done to build out the flat area somewhat. Stretching of the scalp is the limiting factor and you could get about a 10 to 15mm build-up. That I feel would be a mild improvement but I think is inadequate for a significant improvement. It would be better but not ideal. The second and more ideal option is a two-stage approach using a first-stage tissue expander followed by a secondary cranioplasty build-up. This could get upt to 25 to 30mm of skull expansion which ideally is what you need. The tissue expansion provides the necessary creation of additional scalp tissue to cover the size of the build-up tension-free. Computer imaging will show the differences in the result between the two approaches.
Dr. Barry Eppley