How Much Bone Can Be Removed In Occipital Skull Reduction Surgery?

Q: Dr. Eppley, I came across your website and found some of the results of occipital bone reduction surgeries (I could not find a case similar to mine though). As you could see in the attached picture, I have this protrusion that spans all the back of my head up to my neck. I would like to hear from you what could be done to fix it, in as much detail as possible.

From my search on your website, it seems that the solution is through bone burring of a maximum of 6 mm only at the spot of the maximum protrusion. It seems in my case that this will not make a big difference as there will still be some protrusion. Right?

A: Thank you for your inquiry and sending your picture. What you have is an enlarged nuchal ridge line which is the bottom of the exposed occipital skull bone. Most people do not realize how high the back of the skull is which corresponds to the same level as the brow bones in the front. (which is the bottom of the skull in the front) The bottom of the occipital skull (nuchal ridge) is the thickest part of the entire skull so much more bone can be removed here than in other skull areas. (10mms or more) Which would produce a noticeable and likely worthwhile result as I have shown in the illustrated attachment.

Dr. Barry Eppley

Indianapolis, Indiana