How Can I Improve A Prior Back of Head Skull Augmentation That Is Incomplete?

Q: Dr. Eppley, I have a question about skull reshaping (or temporal implant). I have already done a back of head augmentation 4 years ago, but it was in South Korea and with bone cement. I initially suffered from back of head asymmetry. The back and one side was flattened. The operation i have done in South Korea helped for the back of the head, but one side is still a bit flattened. The doctor said it coulnd’t go there because of temporal muscle. The flattening begins juste behind the ear. 

My first question is : is it necessary to remove what have be done with the first operation ? 

And if the answer is yes, is the scar big to remove that ? 

A: What you had done was a bone cement augmentation which must stay restricted to bone as it will not stick to muscle. Because most plagiocephalic back of the head flatness wraps around the side you ended up with incomplete correction.

You can simply add what is missing by a custom implant design from a 3D CT scan which can wrap around the side going from the bone cement and as far forward as needed over the temporal fascia for the correction.

For now I assume the existing scalp incision/scar can be used for placement.

Dr. Barry Eppley

Indianapolis, Indiana