Custom Occipital Implant
Q: Dr. Eppley, I have a very flat back of my head. I’ve never had any problems but as a female I can only wear my hair down and I puff it up everyday so you can’t see it. But by me doing that it is causing hair loss around that area. It is honestly very embarrassing and I am very insecure about it. Also my forehead is flat and the way my nose is shaped does not help at all. So I’m talking maybe three surgeries but I’m not sure how that all works. I have attached a series of pictures so you can see the scope of my concerns. Please reply I would amazingly appreciate it.
A: Thank you for sending your pictures. It is a very classic and common type of occipital-vertex deficiency that I see in women. While it can be very effectively augmented by a custom made implant (custom occipital implant) the question is how much augmentation do you seek…which defines whether it can be done as a single stage or requires a first stage scalp expansion by a tissue expander. Essentially a first stage can augmented the entire area by about 12 to 15mms maximum. A two-stage approach can augment the skull by 25 to 30mms. This is an important consideration up front. Ultimately the question is whether one wants a modest augmentation (one-stage) or a more significant one (two-stage) when it comes to designing a custom occipital implant.
Dr. Barry Eppley