Q: Dr. Eppley, I have a dent in the back of my head and it looks like where the anterior fontanelle is. I have had it as long as I can remember. I like the shape of my head but I want this dent filled so I have a shape that is no longer embarassing. I talked to my GP doc and he couldn’t do anything to help me because it would not be for medical purposes just cosmetic. What would this procedure be called and what specialty of medicine/cosmetics would a doctor be who performs this procedure?
A: What you appear to have is a skull indentation cosmetic deformity in the upper part of the back of your head. This may be where the original posterior fontanelle (not anterior) was. Regardless of why it is there, it is likely a simple contour defect over solid skull bone. This can be treated fairly simply with a variety of onlay cranioplasty materials. Some are placed through small scalp incisions and one of them can even be placed through a minimal incision injectable approach. These procedures are usually performed by either plastic surgeons with craniofacial training or neurosurgeons. When skull defects are purely cosmetic in nature and have no neurologic basis, it would be treated by a plastic surgeon.
Dr. Barry Eppley