How Can I Fix My Fat Back of Head and Prominent Temporal Areas?

Q: Dr. Eppley, Based on the photos I sent, I am concerned about the overall width of my head, particularly the prominent temporal areas and the flat back (occiput). I would like to know if my case could be addressed through temporal reduction (muscle or bone) and/or an occipital implant to balance the proportions. Could you please let me know if these procedures would be appropriate for me? Thank you very much for your time and evaluation.

A:Thank you for your inquiry and sending your pictures. To make sure I have correctly identified your concerns based on the description I have attached your pictures with the areas highlighted but I believe to which you refer. The most straightforward to her correct is that of the occipital deficiency as a custom skull implant will provide an immediate and effective resolution to that problem. From my head widening standpoint you have a high temporal widening which is probably reflective of a boned problem more than that of the muscle. Is the temporal muscle originates from the bony temporal line in that area it usually is thinner than that which lies below it. This means that traditional temporal reduction surgery, which is muscle removal alone, will provide some improvement but probably not optimal. While it would be more ideal to reduce the bone in that area as well, which can be done, I would be concerned about the incisional access to do so given the short hair that you have in that area. Meaning I am leery about the scar trade-off to obtain that additional level of improvement.

As a result, if it were me, I would get the cccipital augmentation and the traditional temple muscle remvoal and then see the level of motivation based on the improvement obtained about whether bony temporal reduction would secondarily be considered.

Dr. Barry Eppley

World-Renowned Plastic Surgeon