What Can Be Done To Correct My Teenage Son’s Flat Back Of His Head?
Q: Dr. Eppley, I am writing to you seeking some advice about my teenage son. When he was a baby (approximately 6 months) we noticed the back of his head was flat. We took him to our family Dr and he said make sure you get him to sleep on his side and rotate him regularly. He also gave us a wedge to try to enforce the side sleeping. To make a very long story short, the little one refused to sleep on anything but his back and nothing we did, helped.
Today he regularly comments on his head shape and how much he hates it. He refuses to cut his hair short because it shows his head shape. I would greatly appreciate some information on the corrective procedure (prep, duration of surgery, recovery time, potential impact on his cycling and costs).
Thank you for your time and consideration.
A: Thank you for your detailed and heartfelt inquiry and detailing your son’s head shape concerns. By your description it appears he has a form of brachycephaly or a flat back of the head. The question is not whether the back of his head can be build out with the placement of a custom skull implant but how much augmentation does he needs to get him to a more self-confident state. I would need to see a side view picture of his head with the recognition that hair is a good camouflage of the extent of the problem. With hair the best way to get a good view of the extent of the flatness is to take a side view picture with his hair wet and combed down.
Once I see a picture of head profile I will do some imaging to convey what I think the placement of a custom skull implant can do. (without tissue expansion first) While a first stage scalp expansion always permits the greatest amount of augmentation there are obvious practical travel considerations that we need to consider.
The custom skull implant is made from a 3D CT scan of his skull. The surgery to place it is a 90 minute procedure under general anesthesia. Given his young age such patients usually stay overnite int the facility in most cases Recovery is mainly about swelling which may or may not make its ways into his face. Such swelling is usually resolved by about 10 days after surgery. Once recovered there are no physical restrictions as such a casual implant is really an inadvertent form of skull protection which can make it much harder to fracture (if not impossible) over the area that it covers.
Dr. Barry Eppley