What Is The Best Treatment for a Right Parasagittal Skull Indentation?
Q: Dr. Eppley, I am a 34 year old male and previously a few years back underwent forehead contouring surgery and fat grafting to the parasagittal areas of the skull (simultaneously) to correct a minor u treated case of craniosynostosis from childhood.
On the right sight of my skull in the parasagittal area, some of the fat grafts either did not take and/or were not distributed evenly because there is a slight concave area which is somewhat noticeable when my hair is cut very short. I previously had an injection of bellafil to correct that spot and I was supposed to go back for more but then ended up relocating to here in the bay area. I would like to correct the rest of that spot if possible.
You can’t see it in a picture really but I attached a photo circling in red the outline of where the concavity is.
I was wondering what options there could be to smooth the concavity and fill the “indented” area. I know there’s fat grafting, spot cranioplasty with bon cement, fillers etc, many of which you offer. I’m wondering what would be effective and also cost efficient?
A: An implant augmentation of some form is going to produce the reliable and sustained effect. A custom skull implant would produce the most effective result. ePTFE sheeting would provide the most cost efficient approach although the aesthetic outcome may not be quite as good as a custom skull implant..
Dr. Barry Eppley
World-Renowned Plastic Surgeon