Every day I get inquiries from patients requesting ‘skull reshaping surgery’ without any further specifications or details of their head shape concerns, not recognizing the scope of the general term. A detailed description of what encompasses skull reshaping surgery is described.
What is Aesthetic Skull Reshaping Surgery
Aesthetic skull reshaping surgery—often called cranial contouring or skull reshaping—is a cosmetic procedure that changes the shape, contours, or proportions of the skull to improve overall head aesthetics.
What it involves
The surgery focuses on the outer shape of the skull, not the brain. Surgeons modify the bone to create a smoother, more balanced appearance. This can include:
- Reducing prominent areas (e.g., a bulging forehead or back of the head)
- Augmenting flat areas using bone cement or implants
- Smoothing irregularities or asymmetries
- Reshaping the brow ridge or crown
Common reasons people get it
- A naturally uneven or asymmetrical skull shape
- Flat spots or contour irregularities from childhood or development
- Prominent bony areas (like a strong brow ridge or occipital bump)
- Desire for a more proportionate or “aesthetic” head shape
How it’s done
- Typically performed under general anesthesia
- Incisions are usually made within the scalp to hide scars
- The surgeon may:
- Shave down bone (burring)
- Add material (usually custom skull implants) to build up areas
- Surgery can take a few hours depending on complexity
Recovery
- Swelling and tightness in the scalp for a few weeks
- Most people return to normal activities in 2–3 weeks, but full healing takes longer
- Hair usually hides any scars once healed
Risks
Like any surgery, it carries risks such as:
- Infection (extremely rare)
- Fluid buildup
- Numbness of the scalp
- Irregular contours requiring revision
It’s a highly specialized procedure, performed by only a few craniofacial or plastic surgeons in tjhe world with extensive xperience in skull anatomy.
What are the Different Types of Aesthetic Skull Reshaping Surgery
Aesthetic skull reshaping isn’t just one procedure—it’s a group of techniques tailored to different parts of the skull and specific contour goals. Here are the main types, organized by area and method:
1. Forehead & Brow Bone Contouring
Focus: Upper face and frontal skull
- Brow bone reduction: Reducing a prominent brow ridge
- Forehead contouring: Smoothing or reshaping the forehead
- Forehead augmentation: Building up a flat or recessed forehead (often with bone cement)
? Common in both cosmetic patients and facial feminization procedures.
2. Occipital (Back of Head) Reshaping
Focus: Rear skull
- Occipital reduction: Reducing a protruding “bump” or knob on the back of the head
- Occipital augmentation: Adding volume to a flat back of the skull
? One of the most requested areas because it affects head profile.
3. Parietal/Temporal (Side of Head) Width Changes
Focus: Sides of the skull
- Used to correct narrow or flat sides of the head, typically involves custom implants for augmentation
- Reduction of a wide or overly convex side of the head, done by subtotal removal or transposition of the temporal muscles
? Helps create a more balanced or proportionatehead shape from the front and back views.
4. Crown (Top of Head) Contouring
Focus: Top of the skull
- Augmentation to increase height or roundness
- Midline reduction of sagittal ridges or crown height
5. Multi-Surface Skull Reshaping (Combination Procedures)
Focus:Overall head shape
- Combines multiple areas (e.g., forehead + crown + back of head)
- Often uses custom-designed implants for a cohesive shape
? This is the most comprehensive and complex approach.
Skull Reshaping Techniques
There are two basic shaping methods:
Reduction (Burring)
- Bone is shaved down
- Best for prominent or protruding areas
- Limited by skull thickness, often checked preoperatibely with a 3D CT skull scan with color thickness mapping of the bone
Augmentation
- Material is added (custom skull implants)
- Used for flat or deficient areas
- Allows more dramatic shape changes
Custom Cranial Implants
- 3D-designed implants based on CT scans
- Used for precise reshaping across one or multiple regions
- Can correct asymmetry or create ideal proportions
Key Concept
Skull reshaping is a general term that refers to a collection of over 30 surgical procedures of either a reductive or augmentative nature to treat a wide variety of undesired head shape concerns. The vast majority of these shape issues are aesthetic in nature and not the severe syndromic skull conditions associated with more well known reconstructive craniofacial surgery techniques..
Dr. Barry Eppley
Plastic Surgeon