How Can I Improve My Cone-Shaped Skull?

Q: Dr. Eppley, I’ve had a considerably flat occiput since infancy as I’ve noticed in pictures from that time.  The vertex of my skull also slopes downwards towards the frontal lobe.  This gives a “cone-shaped” appearance to my head when my hair is cut short. This has never been a concern to me, but in recent years I have began to develop male pattern baldness.  Although I am currently taking drugs to hopefully slow its onset, I must be mindful of my skull shape should the treatment be ineffective.  Having spent a considerable amount of time browsing your website, I’ve determined I may benefit from an implant to the occiput of my skull.

My questions are: what is the cost of such a surgery?  Is there anything that can be done to flatten the vertex of my skull, or would an implant to the occipital lobe just exaggerate the slope?  Would surgery require me to shave my head?  Best and worse case scenarios, how big is the scar post-op? 

I appreciate your time and consideration.

A: It is always more effective to augment the occiput than it is to reduce the vertex. While some bone reduction can be done, there is a limit based on the thickness of the skull to around 5 to 7mms of reducytiopn. The augmentation of the occiput can be as much as 15 mms. But put together a significant change can occur.

For skull reshaping surgery we do not shave any hair although we always appreciate any patients who would like to do so. As a ballpark figure the total cost of this surgery is in the range of $9500.

While all of these issues are relevant, none are more significant than the consideration of a scalp scar in a male. That is the key issue of whether this may be a good procedure for any patient but particularly in men who may have less hair to camouflage it. The scar is placed more to the back of the head keeping it within the stable hairline of most balding men. It is a long scar (12 to 14 cms) but thin.

Dr. Barry Eppley

Indianapolis, Indiana