Q: Hi, After I was born, a hematoma appeared on the back top right corner of my skull (either trauma on the way out of my mom, or trauma suffered after being born…we’re not sure.). It ended up calcifying after being left untreated (at least that’s what doctors have said in the past), and to this day, the lump is still there. It’s about 1.5 inches in diameter and sticks up about 1/2 inch from my skull. This wasn’t necessarily a problem growing up, because hair could cover it up. But unfortunately, genetics have brought on the beginning stages of male pattern baldness. I’m thinning quickly, and a hair transplant seems unlikely at my age of just 23. Therefore, I would like to get used to shaving my hair down, but as we all know, people need a good head shape to pull it off properly. Another side note, but not necessarily as important: I have a prominent forehead that sticks out a bit further than the ridge of my browbone, and my temples are a bit hollowed out. I wear bangs to cover this stuff up as well, but with hair loss, this isn’t feasible in the long run. I’m not sure if these things are fixable, but hopefully I can begin to get some information on what should be done. This stuff is killing my self esteem! I’m a good lookin’ guy! I’m in college! This shouldn’t be happening right now! Looking forward to your response.
A: What you had an birth was a cephalohematoma, a blood collection under the skin and more pertinently under the periosteum of the bone. This is a well known stimulant to bone formation and they are well know to calcify. It can certainly be rather easily burred down which is a simple procedure. The key is to be able to do it with a fairly minimal resultant scar. (incisional access) Given its relatively small size, that should be able to be done with a very minimal scar of about an inch placed vertically on the back of the head at its lower end.
The forehead issues can be similarly treated through burring reduction but the problem is one of hidden surgical access. In the forehead with an unstable hair pattern in a male this is not very feasible. A long scar placed across the top of the head is not a good trade-off. Having a smoother and less bulgy forehead at the expense of a long scalp scar may not be a good aesthetic alternative.
Your temporal hollowing, however, can rather easily be improved through a temporal augmentation procedure. Dermal grafts can be placed under the muscle fascia through small vertical incisions in the temporal scalp. Rounding out the temporal area will help blend in with the forehead shape better.