Q: Dr. Eppley, I am in need of a back of the head skull reshaping procedure for the back of my head. When I cut my hair everybody can see the lump so I’m very frustrated about that and I like to know about this procedure to see what can be done to make that bone reduced in size by in filling around it. I was born like this and it has been there as long as I can remember. What can you do to fill around that bone is sticking out to reduce that size so make it look better? Thank you!
A: Skull reshaping of the back of the head is common for many types of contour issues. I believe the lump on the back of your head to which you refer is a variant of what I call the occipital knob deformity. This lump of thickened bone occurs at the confluence of the nuchal ridge line of the occipital skull in the midline. One could argue whether this bone is too thick or whether the bone that is around it is deficient, either problem of which makes it stick out. From reading your description, it sounds like your concept of contour improvement would come from building up the bone around it using a bone cement material. That is probably the most effective contour approach and would completely eliminate that appearance. That is a very straightforward procedure to do using about 30 grams of material through a small (8 to 9 cm) horizontal incision in the occipital area above the lump and could be done as a 90 minute procedure under anesthesia.
Dr. Barry Eppley