How Much Of My Plagiocephaly Be Improved?

Q: Dr. Eppley, I’m wondering what skull reshaping options there are for plagiocephaly. I would be interested in augmenting the back right side of my head, slight augmentation on the top left side, as well as bridging what I would describe as a divot/dent at the top just above the forehead, as well as reducing the top right forehead and right side a bit due to being pushed forward. I would be interested in the best implant options for the augmentations, as well as the feasiblility of bone burring etc for the reduction.

A:Thank you for your inquiry. All of your skull shape concerns that you have described are common in  plagiocephaly. As you have mentioned in your inquiry the two deficient areas can be successfully augmented by custom skull implants based on your 3-D CT scan. The more protrusive right forehead can also be reduced by bone burning. How much reduction needs to be done and can be successfully completed would be determined by measurements on your 3-D CT scan.

The question is not whether all of these skull areas can be treated with overall improvements. The two pertinent questions are how much effort do you want to put into it (cost) and how much scalp scar burden can you tolerate to do so. These two questions are the defining parameters for your consideration in the treatment of your plagiocephaly. The latter question requires a virtual consultation to clarify. The first question will be outlined by be addressed. A very helpful thing to do when one has a multi-area skull shape concerns is to establish a list of priorities from the most important to the least important. As I have just mentioned the question is never whether you can do all of them but what is the effort versus reward ratio.

Dr. Barry Eppley

World-Renowned Plastic Surgeon