How Much Can My Skull Be Reduced?
Q: Dr. Eppley, Is it possible to reduce the size of a skull/head when it is too big? My head has a circumference of 23.6 inch/60cm. I have attached pictures of where I would reduce the skull to give it a better shape.
A: Thank you for sending the computer imaging showing the areas of your skull you would like reduced. These images make it very clear your areas of concern and I will define these as three skull areas. First, on the low back of the head is the prominence known as the nuchal line. This is a naturally raised area in many people because it serves as the attachment of the neck musculature to the back of the skull. This is why it is thicker and raised. Second, there is a prominence in the bi-occipital width as seen in the front view. Lastly, there is a midline ridge on the top of the skull known as the sagittal line that is prominent giving your skull a bit of a peaked appearance.
Based on these locations and the amount of skull reduction you have shown in the images, I think that is a very achieveable aesthetic change with burring reduction in all areas. The key question is the need for an incision to get there to do it. Given that you are a male with a close shaven head, this is a serious aesthetic consideration. There are two fundamental approaches. A limited posterior scalp incision that will good access to the back of head for nuchal line and bi-occipital width reduction but a more limited reduction of the midline ridge due to the curved surface of the skull and how far the ridge goes frontally. Good access could be obtained to all areas with a full bicoronal incision but that is less desirous in a man with a shaved head.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.