How Much Can The Back of My Head Be Built Out?

Q: Dr. Eppley, I wrote you before to inquire about a Skull reshaping using implants.  I saw the archive “Cranioplasty Category” in your web site which  shows  the case were a  42 year old male was operate,  and an implant was inserted in the back of his skull (occipital)  in order to lengthen and correct a deformity, in this case a flat spot area. I must to say that it is a great job.

I have a similar problem, although it is not exactly like the example posted,  in my case  the flat spot is less notorious,  but the overall profile of my skull is short.  Moreover the rear of my skull is slightly above the level of the forehead. I think its because of some postural plagiocephaly caused when I was a baby.  

I have some questions I want to ask you.  

1) How much my scalp could be elongated in the back of my skull and the final appearance would look natural? 

2) Would  there be a very visible scar ? 

3) Would I have to shave my head for the operation?

4) There is a risk that no hair grows up in the area of the implant ?  cause  i´m not bald

5) How  long would I be hospitalized before and after the process?

I want to have the shape of the occipital area  more pronounced. in order to have a more symmetrical shape of my skull.  I know it´s difficult to answer my questions without  seeing any images, So I could send you pictures of my two profiles to have a better idea.  

A: In answer to your questions:

  1. A s a general rule, the skull can be expanded 10 to 15mm across the back without making scalp closure to tight or precarious for good wound healing.
  2. All forms of craniplasty require access through an incision. It  heals as a fine line but there is a scar nonetheless. That needs to be taken into account when considering a cosmetic skull procedure.
  3. We do not shave any hair for cranioplasties. It is easier for the surgery if a patient did shave their head but we do not do it if the patient does not want to.
  4. The only risk of any hair loss is at the scar, not in the raised scalp flaps.
  5. This is usually done as an outpatient procedure in a surgery center, not a hospital.

Dr. Barry Eppley

Indianapolis, Indiana