How Can I Improve My Peaked Head Shape?

Q: Dr. Eppley, I’d like to inquire about a skull reshaping procedure. I’m looking to address my peaked frontal skull shape along with a mid-line ridge and some other dents along the top and towards the back of my skull in one procedure There seems to be minor-moderate parasagittal deficiencies towards the front of my skull/forehead (not extending all the way to the back) causing the appearance of a peak at the front that is more prominent in certain lighting and from certain angles of view. I have a mid-line ridge also, along with several other minor ‘dents’ along the top and towards the back of my skull including a slightly depressed area at back. I have attached quite a few images to try give a complete idea of the shape of my skull as it is quite hard to capture it in just a few. I guess the deficiencies are not major, but they are apparent in real life situations due to lighting, angles etc. I would estimate that the parasagittal areas would need to be augmented 8-12 mm at highest points. I’m hoping to have the entire top of my skull contoured to a normal, aesthetically pleasing look. A few questions: 1) What approach would you recommend in order to achieve my goal? If custom implant is used, are minor bumps able to be address along with main deficiencies? 2) Would I need scans of my skull for this etc?  3)  How soon could the implant be created and the procedure done once I am ready to commit to the process? Thank you so much for your time

A:Thank you for your inquiry and sending your pictures. In the treatment of the peaked head shaved there are two fundamental approaches which are diametric in nature. For the most minor and least invasive approach some patients may opt for reduction of the peak in the center of the skull which produces a very modest improvement. The other option would be augmentation of the parasagittal and upper temporal areas for a more overall rounded and profound change which requires a custom skull implant to do so. Based on your aesthetic Head reshaping objectives it appears at the latter maybe the preferred approach. In that regard I have attached some imaging of what that potential concept may be able to do.

You have correctly surmised that the fabrication of a custom skull implant  requires a 3-D CT skull scan and it generally takes up to eight weeks to have the implant designed and ready for surgery.

Dr. Barry Eppley

Plastic Surgeon