Q: Dr. Eppley, the question is that I have a flat head. I mean the back of my head is very flat and it really bothers me so that I can’t have short hair. I look very funny or deformed if my hair is too short, what can I do about it? I went through your webside and saw a lot of people had the same problem and you answered their questions. But one thing if i do the surgery I dont care about the scar, but will the surgery effect my hair growth?
A: Skull reshaping surgery and the use of scalp or coronal incisions will not affect your hair growth. The scalp is incredibly thick, around 1.5 to 2 cms for many people. The hair follicles reside in the upper 5 – 7mms of the dermis of the skin and protrude just below it into the subcutaneous fat. They are easy to see and it is important in surgical technique to avoid injuring them. (no use of cautery in making the incision, meticulous skin closure)The point being is that there is a low of tissue between the bone work and where the hair follicles live. The only issue of any potential hair loss is right around the incision not anywhere elese.The issue, therefore, for any patient is acceptance of a scar from the incision not one of hair growth.
Dr. Barry Eppley
Q: Dr. Eppley, I am interested in skull reshaping for a prominent ridge down the center of my head. But I am concerned about the scar that is needed for the surgery. What are your thoughts on the scar and what can be done to make it heal the best?
A: The scalp scar in men for any type of skull or forehead surgery is always an issue to ponder very carefully. Whether it is worth it or not depends on a variety of factors including the magnitude of the deformity and one’s concern/focus on it, hair follicle density and hair style and the location of the scar on one’s scalp. I have done numerous skull reshaping procedures on men who are bald or shave their heads and the scar for them has been worth the trade-off. But I am certain that it was an acceptable aetsthetic trade-off because this very issue was discussed at great length beforehand and they have had plenty of time to make the proper determination for themselves about the scar trade-off. Scalp scars generally heal very well and how well they heal is largely determined by how the incision was made and how carefully it is closed with respect to preserving hair follicles.
Dr. Barry Eppley