Q: Dr. Eppley, I see you have posted blogs on removal of cephalohematoma on skulls and also filling in flat spots with a bone cement. My son was born with a cephalohematoma on the back left of his skull. He was also prone to sleep on the left side of his head and has caused a slight depression on that side. We have been doing head positioning every day and he is now 2.5 years old. If we were to consider plastic surgery, when is a good age to do this to fix both issues?
A: When fixing any cosmetic skull deformity in a child, there are two relevant issues. First, when is skull growth stable? In other words, when can you correct the asymmetry and have a reasonable expectation that the skull asymmetry will not recur or ‘regrow’? There is not an etched in stone answer and later is always safer in this regard than sooner. In general, when a child reaches 3 or 4 years of age, much of skull growth is completed and the risk of any recurrence is very small. Secondly, when is the best psychological time to intervene with surgery in a child who can not speak for themselves and may not know for a long time if their skull shape is even an issue for them in the future? This is only an issue that a parent can answer, and like many child-rearing decisions, has to be driven by what the parent thinks is best for them based on how they look now.
Dr. Barry Eppley