Is An External Skull Reshaping or a Craniotomy Better for My skull Problem?

Q: Dr. Eppley, I have a particular head which is pointed at the top and flattened behind. I have already had several consultations of which opinions are different. Thus I am confused. One opinion was to fill the flat areas by a material without touching the  pointed top. Others proposed a craniotomy to cut the bone and reposition it so that the lump is found in the back and the flattening will be  up at the top. Since I know you have great experience in craniofacial surgery and am familiar with many ways to change the shape of the skull, what are your thoughts between these two skull reshaping options?

A: While I have not seen a picture of you, I can only make some general comments. The preferred and more practical treatment to your skull concerns would be to do an external  skull reshaping technique. This would be to burr down the ridge/high spots as much as possible and build up the flat areas with a cranioplasty material. The converse approach would be a craniotomy in which the bone is completely removed and reshaped. This would be a very aggressive approach to a cosmetic problem which is fraught with potential problems when attempted to be done in the very thick and vascular bone of  an adult.

Dr. Barry Eppley

Indianapolis, Indiana