Occipital Knob Reduction
Q: Dr. Eppley, I had contacted you about a year ago about my occipital knob reduction surgery. I have since been saving money for this procedure with you. I have also been following procedures you have performed and posted on your website. One that I found very impressive was the occipital implant with knob reduction using a custom implant. I have taken some more profile pictures and played around with possible outcomes. I have attached those to this email. If you could please give me your suggestions and opinions on this that would be great.
A: Good to hear from you again. What you have shown would be a beautiful addition to your occipital knob reduction since you really have a combined occipital problem of a lower protrusion (occipital knob) and an upper deficiency. (occipital flatness) Normally an occipital implant is done by a custom approach using a 3D CT scan. But I have done so many of these occipital implants that in some cases, to save money and still get a good result, I will use another patient’s occipital implant design. (this is known as a semi-custom implant) That saves a fair amount of money and the shape of the flat back of the head is only minimally different amongst most patients as long as there is not a significant occipital asymmetry. The implant is also flexible so there is a lot of give for its fit onto the bone. (once on the bone it feels hard just like bone however)
Dr. Barry Eppley