Q: Dr. Eppley, I am a 30 year old male with a odd shape head that hunts me still now. I keep a lot of hair on my head to give my head a fuller look. I also constantly cover my head with a bandanna, sleep with it on my head, never remove it. My head sweats, get dried and builds up a bad case of dander because I hate my head shape and smallness…. I need help with this problem and people is driving me crazy, I haven’t been outside normally for 13 years, only go out when I have no choice. It is all my mother fault, she shaped my head by pressing on it when I was a child because she believed wide flat foreheads are a great look for men but she done it all wrong, I am flat front and back, my skull is small as well…. please help me!
A: Your description of your unhappy head shape sounds like fronto-occipital flatness. This could be improved by augmentation of your forehead and the back of your head by an onlay cranioplasty. Whether both areas should be done or just the front or the back would depend on the area of the greatest aesthetic concern. How much augmentation can be done depends on what your scalp will permit by stretching. By using a coronal scalp incision between the two areas, good scalp expansion can be obtained and the closure of the incision is well away from the material location which is always a bonus.
Dr. Barry Eppley