What Is The Best Approach To Fix Plagiocephaly in Adults?

Q: Dr. Eppley, As we both know plagiocephaly causes twisted/forward growth of one side of the face. I have this predicament on the right side, where my forehead protrudes out further, and my jaw is more rounder and its lower, also “twisting” towards the left side. I can feel how my zygomatic bone is less developed on this effected side as well.

A few questions

1. Is it easier to treat plagiocephaly by fixing the “pushed out” side or the side that sits normally?

2. My forehead sits protrudes out on the right side, while my left one sits flush and normally. Would it be easier to mirror the left side by shaving down bone on the right side, or mirroing the right side with implants / fillers? The left side sits more sloped and masculine, which I prefer, but if the former is easier I would consider doing it.

3.Unfortunately it seems my entire skull on the right side is flatter as well, from the temple points all the way to the occipital, would it be possible to fix the side of the head projection and the back?

Thank you

A:In answer to your plagiocephaly questions:

1) How ‘easy’ it is to improve the abnormal expanded asymmetric depends on the magnitude of the excess and what exact procedure needs to be done to fix it. That can really only be determined by assessment of a 3D CT scan to assessment how much reduction needs to be done.

2) This answer is the same as #1. The question its how much bone needs to be removed to mirror the left forehead. Only measurements taken from the 3D CT scan can answer if that is surgically possible based on the thickness of the right frontal bone.

3) Adding projection to the entire right side of the head to the back would be done by a custom implant made from the 3D CT scan to match the fullness in the right side.

As you can see in all of the above answers the key is the 3D CT scan from the proper diagnosis and subsequent treatment planning. You can not do so by just looking on the outside.

Dr. Barry Eppley

Indianapolis, Indiana