How Many Skull Reshaping Procedues Can Be Done At The Same Time?

Q: Dr. Eppley, I have attached some pictures however the camera quality is poor. I have also added privacy features for privacy reasons as you can imagine this is a sensitive issue for me and I want to maintain as much privacy as possible. Despite the poor camera quality and how the pictures look overall, I am serious about doing the procedure. 

The ideal outcome would be to improve overall head shape by doing a sagittal dip correction in addition to doing a forehead reduction and recontouring for the forehead area to appear more flat in appearance. I am also seeking to correct temporal bulges on the sides of my head and to correct occipital flattening/asymmetry.

Please let me know what the best option to achieve the outcome I am looking for, the possible cost, timeline for the procedure to be done and any other relevant information.

A: Thank you for sending all of your pictures. Based on the pictures and your description you are referring to a comprehensive 5 surface skull reshaping procedure which includes from front to back:

1) Forehead Reduction

2) Sagittal Dip Correction

3) Bilateral Temporal Reductions

4) Occipital-Parietal Augmentation

All of these skull reshaping procedures can be done at the same time. There are two options we need to consider which will affect the cost of the surgery…1) incisional access and 2) what type of implant material. The best way to all four procedures is through a coronal scalp incision and the only way such a forehead reduction can be done. This scar tradeoff may preclude the forehead reduction part of the procedure. All other procedures can be done through very small separate incisions where the scar tradeoff is not a major consideration. The implant materials could be either bone cement or custom skull implants. The former requires a coronal scalp incision to use while custom implants can be placed the previously mentionde small incision.

Thus I need to know what you want to do from an incisional standpoint as that will dictate what can be done and the cost to do it.

Dr. Barry Eppley

World-Renowned Plastic Surgeon