Cutis Verticis Gyrata
Q: Dr. Eppley, I came across one of your publications on the Internet regarding cutis verticis gyrata scalp condition.You recommend fat grafting to treat this condition.
A doctor I have consulted (where I am living) also recommend me to try this procedure. But I am not sure about the efficiency of this procedure. Would you mind to advise if fat grafting technique could be a good option to solve my case ? I have attached pictures of my scalp so you can have look. I am looking forward to hearing from you.
A: Cutis verticis gyrata of the scalp is a very unique, peculiar and fairly rare scalp condition. Why it is occurs is not known and how to really effectively treat it is similarly not known. The vertical grooves or grata are scalp indentations (not bone) that become fibrotic and adhered down to the bone. This adherence is quite dense and unbelievably stiff. There is almost nothing but scar tissue between the skin of the scalp and the bone. The only really viable treatment option is injectable fat grafting. Having done that procedure it is really hard to get into and raise the grata to place the fat grafts. It takes an initial release with ‘picklefork’ instruments to get the tissue separated to create the tissue plane to place the fat. And it will likely take more than one fat grafting session to get the best result. But you would have a good idea after the first treatment session of the value of doing further fat injection treatments.
Dr. Barry Eppley