Q: Dr. Eppley, I have always been insecure about my head shape and I wanted to know what exactly can be done and the cost. I would like a forehead reduction and the back of head reduction as well. I have provided a left and right profile image of my head. Please advise on what can be done. My head isn’t extremely large its just my forehead sticks out too much for my liking and also the back of my head but tell me your honest opinion. Thank you.
A: Thank you for your inquiry and sending your pictures. While both the forehead and back of the head protrusions can be reduced significantly, my concern is the resultant scars from the incisions to do. The back of head reduction is less of an issue because a relatively small horizontal incision can be made directly over it to reduce it and that scar line always heals very well. The only reasonably acceptable incision to approach the forehead is through a hairline incision right at the edge of the hairline.While that usually also heals very well, it does gove me some pause with your ethnicity and type of hair.
In my opinion the back sticks out further and is more ‘abnormal’ than the forehead but I think you probably feel the opposite about the two…and your opinion is really the only one that counts.
Dr. Barry Eppley
Q: Dr. Eppley, I am interested in skull reshaping reduction of the size of the back of my head. For a long time, I have had a distressing issue with the prominence of the back of my head in what I believe to be the occipital bone region. The problem is primarily located slightly right of centre of the back of my head. In other words, from side view, my head sticks out more on the right side than it does on the left and the bone can visibly be felt as thicker and more protruding. It also doesn’t help that my crown area feels very flat and almost leads into a boat shape back of the head. After much research, I do not necessarily believe that I have a form of craniosynostosis, though I am not ruling out the possibility of perhaps a mild manifestation of it.
As a young 25 year-old man, are there options out there for me to possibly reduce the ‘sticking out’ of the back of my head, so that I can have a more ‘normal’, flatter back of the head? I have attached two photos, taken from either side of my head, so that you can notice how one side sticks out more than the other (though my occipital bone in general sticks out much more than normal). I also appreciate that it may be hard to tell by the photos because of my hair coverage, which I keep as an attempt to mask the bumps. I understand that things of this nature are usually dealt with more in children but I came across your site when researching possibilities for occipital reduction.
A: Skull reshaping of the prominent back of the head is very common in my practice. It is never a question of whether occipital bone reduction can be done, it is always a question of whether the reduction achieved will be significant enough to justify the effort. As a general rule, 5 to 7mms of occipital bone can be reduced. That may not sound like much but usually produces a noticeable size reduction. Just based on your description of the problem, it sounds like this amount of reduction would be adequate to make a difference in your back of the head shape.
Dr. Barry Eppley