Custom Skull Implant
Q: Dr. Eppley, I am interested in skull augmentation or skull reshaping, I don’t know which is the right term. I feel it’s from the back of my head circumferentially around the sides. When I push fthe ront of my hair up (to increase volume) I feel my face looks normally. But when I take my hair tightly I feel my head is smaller than my face.
I am really sad and frustrated. I feel there is no way that I can feel normal I even went to a good plastic surgeon for a consultation but after 5 minutes he said it’s genetics and not worth it to be corrected.The only doctor that I found is really supportive is you.
I think my problem is more than just cosmetic, I I don’t look normal and I cannot do normal activities like swimming. I always have to use many clips to push my hair up.
I really appreciate your kind support.
A: Your description of your skull/head shape problem is one that I have heard from female patients many times. The skull size descriptions and their aesthetic concerns and psychological effects are identical. Their is a solution to these skull size concerns and it involves a custom skull implant that adds volume to the head in exactly the areas you feel are most deficient. But there are two ways to use such a custom implant and they will create different results.
Having had patients just like you I have a good feel for the amount of additional skull volume you need. Thus the ideal approach is a two-stage one. The first stage is the placement of a tissue expander for 4 to 6 weeks to create the scalp stretch that is needed for the size of skull implant that will create the ideal result. The second approach is one-stage with the placement of a smaller skull implant without doing scalp expansion first. The way to think about choosing is what type of result are you willing to accept for the effort invested? If you can live with improvement and 50% to 75% of the ideal result then place a custom skull implant without scalp expansion. If only the ideal skull height/shape increase will do the do the two-stage approach. Be aware that once you have an implant placed you can do not do scalp expansion later. (should one decide afterwards that they want more volume. Obviously the one-stage approach is quicker and costs less…but you have to be prepared to accept improvement in skull size but not perfection.
Dr. Barry Eppley