Skull Reshaping Surgery for Sagittal Ridge Deformity

Q: Dr. Eppley, I am interested in skull reshaping surgery. Please see the attached picture. I hope this provides an adequate image of my skull shape despite my current hair length (note my hair is very wet and patted down in these images). Please let me know if more shots from different angles would be beneficial. As you can see, my sagittal crest is very pronounced and is noticeable even with a full head of hair. I am looking for a smoother ‘outline’ of the skull, visible from both the front and side perspectives. I am hoping that the bone is dense enough in this area to allow for maximum reduction.

A: Thank you for sending your pictures. What you have is a combined sagittal ridge with a parasagittal deficiency. (actually the parasagittal deficiency is they bigger problem, it only looks like a ridge because of it) This is why sagittal ridge reduction (see attached imaging) of maximal amount (7mms) is woefully inadequate to treat the problem. What you really need is a combined sagittal ridge reduction with parasagittal augmentation. (see attached imaging) The parasagittal augmentation also needs to extend around the back as you have an upper parietal skull deficiency as well. (see attached imaging) Before I saw your pictures I knew this was going to be the overall skull shape problem because, when it showed through one’s hair, it is always more than just an isolated sagittal ridge.

Dr. Barry Eppley

Indianapolis, Indiana