Background: The height of the head can be an important aesthetic issue for some women. Flat or low skull height over the crown area can be seen as an undesirable physical feature. Women will often try to camouflage the lack of crown height by altering their hairstyle with ‘hair heightening’. While this can be effective, it is time consuming and tedious. And not all women have enough hair density to do this adequately.
This aesthetic skull height concern is illustrated by the invention known as the Bumpit. This semicircular plastic insert on the scalp allows the hair to be ‘volumized’ which makes the height of the head appear taller. While claimed as being a silly and useless invention, the women that use it and find it effective probably do not see it as such.
A surgical and invasive method to create a partial Bumpit effect is the use of a custom skull implant. As a one stage procedure it may allow in some cases for the crown skull height to be augmented from 8 to 12mms. (which is roughly half of the typical Bumpit height of about 25mms) But its effects covers a broader surface area of the skull to blend into the sides of the head with a smooth tapered transition.
Case Study: This 35 year-old female had been bothered by her flat head. She spent a lot of time fixing her hair to hide it and would not go out without a hat when she didn’t have the time to fix her hair. She finally decided to seek a surgical solution. Using a 3D CT scan a custom skull implant was designed to increase her skull height by 9mms at the most central height of the crown
Under general anesthesia and in the beach chair position, a limited coronal scalp incision was made.Wide subperiosteal undermining that went just beyond the boundaries of the planned implant size, the pocket was developed. The custom skull implant was opened and muttiple 4mm perfusion holes were placed using a dermal punch. The implant was then inserted and oriented into place using the ‘compass’ markings in the implant. A two later was done for closing the scalp up over the implant. No drain was used
The skull height augmentation was clearly evident and sufficient to satisfy the patient. A one stage custom skull implant can safely create an additional 1 cm of height using a limited scalp incision approach. While greater scalp laxity can be obtained with a full coronal incision from ear to ear, that scar tradeoff for many women may not be worth it. If one needs more than 1 cm of additional skull height, consideration has to be given to a first stage scalp tissue expander,
Highlights:
1) Some women may not have adequate height to the crown of their head for their aesthetic desire.
2) The Bumpit Custom Skull Implant is designed to create additional crown skull height from being placed under the scalp.
3) The extent of ‘scalp heightening’ that can be achieved with a custom skull implant is determined by the extent of scalp stretch that can safely cover the expanded bone height underneath it.
Dr. Barry Eppley