How Low On The Back Of The Head Can Skull Augmentation Go?

Q: Dr. Eppley, I got my custom skull implant for the beck of my head last December and you did tell me after a while that my swelling would go down. I’ve definitely noticed some things, and wanted to know if he did anything for the more bottom part of the back of the head! I made some marks as to kinda where I want it. Thank you kindly:)

A: Thanks for the longer term followup. The diagram you have shown illustrates a common misconception of where the occipital bone actually ends on the back of the head. The bottom end of the skull on the back of the head is actually at the same level as the brow bones are on the front of the skull. This places the end of the bone at the same level of the top of the ear…much higher than most people think. (see attached diagram)

At the end of the occipital skull bone attaches the neck muscles. So if a skull implant design extends below the bone unto the surface of the muscle, which can be done, there is always the risk of potentially causing some discomfort when one extends their head backwards. I suspect this risk would be reduced/obviated if the skull implant had a softer edge. (lower durometer implant material)

Looking at your current skull implant design at 125ccs, much of its volume was desired at the very flat upper back of the head, and it has done a good job of solving that issue. Even if we had wanted to augment the bottom part of the skull, including below the bone edge, we would not have been able to do so originally as that total implant volume would have been in the range of 175cc to 200ccs…a volume beyond what your scalp stretch could initially accommodate.

With an indwelling skull implant it acts as a scalp tissue expander which now would permit a new skull implant design that could provide coverage/volume in your desired areas.

Dr. Barry Eppley

Indianapolis, Indiana