Q: Hi, Dr. Eppley. I have a really flat head. I can hide it by blow drying my hair, using gels and any volumizing products to make my head look not so flat. My hair is very short and has lots of layers at the back of my head so it hide it pretty well.. Is there a surgery for flat heads to make it not flat? If so, what’s it called? Have you done any surgeries for flat heads before?
A: When most people refer to having a flat head, there are talking about the back part. Sometimes it is one side but, most of the time, it is both sides. This is called occipital plagiocephaly, either unilateral (one-sided) or bilateral. (both sides) This flatness is always at the upper part of the back of the head, which is the bony or skull part. Down low, it become more neck muscle and less bone. Building this area ouot (augmentation) is done the same way as it is in the forehead through an onlay cranioplasty technique. This is done by adding a bone-like material onto the top of the bone in the amount that will satisfactorily expand out the bony contour and make it more rounded. The critical decisions about occipital cranioplasty is what type of incision to place and what type of cranioplasty material to use. The type of cranioplasty material influences the incisional approach. A vertical incision is used down the back of head (open technique) where either acrylic or hydroxyapatite materials can be placed. This offers the best and smoothest shape. A smaller vertical incision can also be used (endoscopic or injection technique) in which only Kryptonite material can be used. While offering a smaller incision, the trade-off is in the difficulty in getting a perfectly smooth shape.