Can I Get An Occipital Cranioplasty If I Have Had Hair Transplantation?

Q: Dr. Eppley, I’m interested in occipital cranioplasty, and I have a couple of questions. The flat area is on the upper part of my head. I will be having hair transplant surgery and right now I’m probably a Class V. If I want to go ahead with the cranioplasty should I do it before the transplant procedures or after. I will have to have at least two sessions and I might not be a candidate for FUE. If that’s the case then the strip method will be used and the doctor will have to undermine my scalp. I’m afraid that if the cranioplasty is done first the doctor might have trouble undermining my scalp for the transplant. Second, with the cranioplasty I would want the stronger material (acrylic) and would want it to be fixed to the bone with screws, mostly because I’m active. The question is, would I be able to do a headstand with the material attached to my skull? Would it hold up to my full weight even if I do neck bridges, like in judo? Or once I have it done I would have to kiss those kinds of exercises goodbye? I would want that puppy in there permanently and solidly attached to the back of my head.

A: When it comes to occipital cranioplasty and hair transplantation done with the strip method, they are mutually exclusive. Occipital cranioplasty requires scalp expansion of which strip harvesting takes away scalp in the same general area. The two can never be done on the same patient no matter how they are sequenced. There is also the issue of vascular compromise to the posterior scalp caused by strip harvesting which make the blood supply to the scalp precarious in the midline if an occipital scalp flap was ever raised.

Dr. Barry Eppley

Indianapolis, Indiana