Your Questions
Your Questions
Q: Dr. Eppley, can we practice an onlay cranioplasty with tkryptonite in the front of the skull and end up having a smooth forehead shape? Are the most common complications of kryptonite cranioplasty surface irregular and a palpable demarcation between the bone of the skull and the kryptonite in certain areas? What is the likelihood that a second would be needed to smooth the surface of the kryptonite? If the demarcation between the bone of the skull and the kryptonite is especially annoying on the forehead after surgery, what is the solution?
A: In answer to our specific questions:
1) It will not likely create a smooth contour.
2) What you have mentioned are the two aesthetic complications with an injectable or minimal incision kryptonite cranioplasty.
3) It can be done endoscopically (small scalp incisions) with a long handled rasp.
4) It will be and it is corrected secondarily as mentioned in #3.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am a 30 year old male and I have a flattened skull at back, which I understand to be plagiocephaly. This has until now been fairly well-covered with hair, but I am beginning to recede at the temples, and so I am becoming increasingly concerned about it, should I go bald. I am therefore interested in exploring possible treatments- I hear you offer a cranioplasty procedure involving injectable kryptonite? I would be very interested in hearing more about this- in terms of how successful/established the procedure is, likely cost and potential risks. Any information you could provide would be really useful. I appreciate it may be difficult to provide a concrete answer without a full consultation, but any general information would be really useful.
A: I would seek out any postings that I have written using Kryptonite cement for skull reshaping which would appear on a Google search. I have written extensively about it and all of your questions would probably be answered there. In summary, it is a developing technique that is far from perfected with the biggest complication being irregularities and the potential need for a smoothing revision. But it is a simple one hour procedure that involves minimal recovery using only a one inch incision. The cost of this cranioplasty procedure is largely driven by the volume of the material that is used. The cost of the material will easily make up more than half of the cost of the surgery.
Dr. Barry Eppley
Indianapolis, Indiana
Q: The back of my head is very flat. As a child in school, they used to make fun of me because the back of my head was so flat. While I want to wear my hair short, I can’t because it becomes really apparent. I have attached some pictures showing how flat it is. Because of my longer hair, I have drawn a line indicating the actual shape of my head beneath my hair. I want to add up to an inch to the whole backside of my head to give a more rounded shape. Do you think it is possible with the Kryptonite material and not having to make a big incision across the back of my head?
A: Thank you for sending your pictures. It is easy to see, even with your hair, how flat the back of your head is. Yes it is possible to build out the back of your head with a minimally invasive cranioplasty technique using Kryptonite. However there are several caveats about the outcome with this cranioplasty method. The build-out of your skull can not go below the lowest level of the occipital bones which is about at the mid-level of the ear. (you can feel how high the end of the occipital bone sits with your fingers. Most people think that the bone goes much lower than it does. Any cranioplasty material can only be put on bone not muscle. A skull build-out of as much as an inch may be too extreme due to scalp expansion issues, a more likely result is 1/2″ to 3/4″ at the very center. (midline)
Dr. Barry Eppley
Indianapolis, Indiana
Q: Hi Doctor Eppley. I’m a 19 years of age male and I have a mild flat spot on the back of my head. It’s not that bad but I would still like to know if it’s possible to treat it and be able to achieve good aesthetic results and shape it to be more round. Also, I have read some questions and answers of people that have have a similar problem, and you responded by saying that this problem can be treated by using regular cranioplasty making a large incision, or by injecting Kryptonite with a much smaller incision. What is the difference between the two, in terms of healing process, reliability, aesthetics? etc. Is the surgery going to leave any visible permanent scars? I’m really looking forward for your response.
A: By your own description, you have a mild depression on the back of your head. That would indicate that an open form of cranioplasty with causes a long scar would not be an appropriate solution. With that approach, the treatment may cause a worse aaesthetic problem (scar) than the area of skull flattening. That leaves you with the option of the injectable Kryptonite approach. That uses a very minimal incision and the resultant scar is never an issue. It is a minimalist procedure with very little reovery. The material sets up with the consistency of bone so it is very stable and impact resistant. The only potential issue with this approach is trying to get a nice smooth round profile which for just one side of skull flattening is very achievable.
Dr. Barry Eppley
Indianapolis Indiana
Q: Hello, I just have a few questions about a cosmetic issue that I have been dealing with for really all of my life, but just became totally aware of within the last few years. I have a condition called Plagiocephaly. I’m sure you know what that is, so I won’t go into that. I will say, however, that I have a flat spot on the left side of my head. It has caused my left ear to protrude, and my left brow ridge(the part that the eye brow covers), also protrudes. It is very noticeable, especially to me, but others do notice it too. My question is whether or not I can have a procedure done to either A.) Reconstruct the left side of my head and brow ridge so it looks more symmetrical with the other side of my head, or B.) Just correct one of the two areas. I really would like both done and I would like to know about scarring and what would they look like, and whether they would be covered by my hair or not.
A: The physical changes that you have described are classic for occipital plagiocephaly in children and adults in which the condition was not treated early or was felt not to be severe enough for traditional skull molding therapy. On the same side, one can have a flat spot on the back of the head, a brow protrusion and an ear that sticks out more than the other side.
All three cosmetic problems can be effectively treated through known plastic surgery procedures. These include an injectable occipital cranioplasty using Kryptonite material (limited scar technique), a simple ear setback (otoplasty) , and a burring down of the tail of the eyebrow (brow bone reduction) using an endoscopic technique. All three can be treated during a single operation or only the most bothersome can be treated alone.
Indianapolis, Indiana
