Occipital Augmentation

Q: Dr. Eppley, I am interested in occipital augmentation surgery. My 5 year old son has a flat spot on the back of his head. We consulted out pediatrician about it from an early age and were told it would “round out”. It didn’t so at 18 months we paid out of pocket for a helmet and got minimal results because of he was passed the age of best results. 

This has caused a lot of pain and regret for us even though my son doesn’t have a clue that anything is wrong. At what age is it safe to consider doing something about the issue? We don’t want him to face any social issues because of bad advice from our pediatrician and late action on our part. What are our options?

A: The aesthetic correction of unilateral occipital plagiocephaly by occipital augmentation can really be done at just about any age in my opinion. Correction involves building out the bone with hydroxyapatite bone cement (at at early age) or a custom made implant at older ages. Whatever is placed on the bone will grow with the slowly expanding skull growth. I think hydroxyapatite cement is most appropriate for young children since its the inorganic mineral content is most similar to bone. The decision and timing for occipital augmentation surgery at this point in your son is a personal one and is most appropriately done when you and your wide deem it most psychologically protective.

Dr. Barry Eppley

Indianapolis, Indiana