Will Fat Grafting Work To Fix My Scalp Indentations?
Q: Dr. Eppley, I’m a relatively young male and over the last 2 years my scalp has been gradually depleted of soft tissue due to a connective tissue disease that I have. I now have several indentations all over my head that were never visible until recently. You answered my RealSelf question about this, stating the surgical options were either fat grafting , or implants. My question is you said that fat grafting doesn’t always work well on the head, why is that? And two, if it were to be implants, would they be super visible on the edges and what would happen if my scalp continued getting deeper dents underneath the implant?
A: Since these indentations are soft tissue based the logical approach would be soft tissue grafting with fat injections. While injection fat grafting placed anywhere always has unpredictable survival/volume retention rates, certain body areas are more favorable while others are known to be less favorable. The scalp is an unfavorable site because it is composed of tight tissue layers that do not naturally have much fat in them. (fat survives best in areas which naturally have more fat) But that being said fat graftng is still the way to initially go and does not mean it would not be effective. Implants would only be considered when fat grafting has proven to be ineffective.
Dr. Barry Eppley