Q: Dr. Eppley, I am a 28 year old male. I was always bothered by a flat spot on the back of my head. It has a profound effect on my confidence and makes me feel very self-conscious about myself. Even though it is not terribly bad, I would still like to get it corrected. Going through similar cases on your website, I would like to know if I will be a good candidate for the minimally invasive closed cranioplasty approach. What is the success rate of such a procedure? Are there any side effects? How long does it take for the scar to heal and will it be visible? How large of an incision will be needed? I have attached a photo of back of my head. Also, my hair is currently thinning on my crown area. I would like to get an FUE hair transplant. Is it recommended to do the hair transplant first prior to the cranioplasty or vice versa? Will cranioplasty have any effect on hair growth in general?
A: The best and only way I will do occipital augmentation today is using semi-custom or custom occipital implant placed through a low occipital incision. (general 9cms in length) This has a high rate of success (as long as one is not asking to achieve more than 10 to 15mms of augmentation) and a low rate of revision. A closed cranioplasty procedure has a high incidence of irregularities and asymmetry…which can only be revised then by an open cranioplasty approach.
Occipital implants do not cause hair loss. When it comes to hair transplantation, the impact of occipital augmentation depends on what method of FUE harvest is going to be done. If one is going to have a traditional linear strip harvest then one should have an occipital implant as least one year before the procedure to allow the scalp to relax. But one would be unlikely to get more than one harvest so ideally this FUR harvest method should not be used. If more contemporary methods of harvest are going to be used (Neograft, Artess) then the hair transplant procedure can be done six months after the occipital implant is placed.
Dr. Barry Eppley