How Can I Fix My Temporal Muscle Atrophy After A Craniotomy?

Q: Dr. Eppley, I have a dent on the left side of my head, as a result of a head operation a year ago and the skull has been installed, but I have a small dent on the left side because my head muscles have shrunk, can the dent be repaired?

A:This is a classic indentation from temporal muscle atrophy after a craniotomy. The muscle volume has been lost as the muscle has shrunken down after being elevated to do the bone flap. And even though the muscle was resuspended the muscle shrinks because its point of bony origin has been disrupted. Because the muscle has shrunk its size/volume can not be augmented. It now requires an implant to be paced on top of the muscle under the scalp to fix the temporal concavity. There are numerous implant material to do so. The implant footprint would probably look similar to the attached diagram with 5 to 6mms thickness.