How Much Skull Reduction Can Be Done?

Q: Dr. Eppley, I have a pituitary tumor that made my skull grow very big. The pituitary tumor has been removed now and I am cured and cleared by my doctors. But the size of my skull is too big and very bothersome to me. It is very negatively impacting my self-image. My skull is too high up top and slopes down in the back. The temporal areas also stick out too far. How much skull reduction can be done to help me?

A: What I can tell you, with a lot of skull surgery experience, is that you can’t go deeper than the outer cranial table which often is anywhere from 5 to 7mms thick. Yours may or may not be thicker than that is some areas. At that point you enter the diploic space where a lot of bleeding occurs and the inner cranial table is not much further away. That is the limit of safety for any skull reduction procedure.

While 7mms may not sound like a lot of reduction, when done in a lot of areas of the skull, the external or visible appearance can be a lot more significant than the number sounds. It is common that patients think they need a lot more skull thickness reduction than they really do. I didn’t say that such a skull reduction result would be perfect or ever as much as some patients want. But is usually enough that patients feel it made a real difference.

Dr. Barry Eppley