Which Is Better For Skull Augmentation – Fat Injections or a Custom Skull Implant?

Q: Dr. Eppley, I’m contacting you because I’ve had a complex about the shape of my skull for several years. Indeed, I find that my skull has the shape of an inverted “V” on the posterior saggital part. Consequently, as my hair is fine, flat and without volume, I have a hairstyle that looks like a  “triangle” and this is not flattering.  Also, when I tilt my head forward, the pointed side of my skull appears and the shape is not that of a harmonious rounding. When I tie my hair, I always pay attention to the elastic band to try to hide the defect of my head but often, the shape is still visible. I have added several photos as attachments so that you can see.

I have several questions if you agree to answer them:

First, I would like to know if you could suggest an aesthetic procedure to improve the shape of this part of my skull, to make it more rounded and harmonious, and if it would have a real aesthetic benefit for the overall beauty of my head (face + skull).

Would injections of my own fat be enough to improve the aesthetic aspect of my skull?

If not, should I consider a custom-made implant?

As I live in Europe, I would like to know if you have a colleague to recommend to me who works like you on cranial contouring. 

Finally, could you give me a price range for such an operation?

Thank you in advance for your answer.

Best wishes,

A: Thank you for your inquiry, detailing your head shape concerns and sending your pictures. The definitive treatment for a scaphocephalic head shape is to either reduce the posterior sagittal crest (#1), bilateral parasagittal/temporal line augmentation (#2) or a combination of both. (#3) I will discard #1 and 3 for now and focus on #2 (volume addition) to which I can say the following:

1) While fat injections can be done anywhere, including the head, their volume retention in the tight scalp is precarious at best. But there is certainly no harm in doing so as a first attempt at skull augmentation. But the risk is high for either complete resorption or a minimal augmentation effect.

2) The definite and assured method of skull augmentation is a custom skull implant that is precisely made for your anatomy and aesthetic requirements. This is a common aesthetic skull augmentation procedure in my experience.

3) I am not aware of any European surgeons that perform this type of aesthetic skull reshaping surgery.

Dr. Barry Eppley

Indianapolis, Indiana