Background: The shape of the head has importance to many people whether they have good hair cover or not. It should be no surprise that men who lack good hair cover or shave their heads make up a greater percent of aesthetic skull augmentation than that of women. At the least their head reshaping goals are usually different than that of women.
The most common head reshaping concern for women is a crown deficiency. The crown of the head starts at the top of the head where it starts to curve downward to the back and ends at a point just above the nuchal ride of the occiput. The center of the crown is usually where the hair often swirl or radiates outward from a central area in the center of it. It is a semicircular area that looks like a cap that is sitting little too far towards the back of the head.
Many women value a good crown skull height. When it is inadequate they often will tease their hair up to create the illusion of a higher natural crown shape. While this can be effective for some women with good hair density, they may fatigue of this practice or may not have he hair density to create a satisfactory illusion.
Case Study: This young female was bothered by the flat top of her head with no crown height. Her 3D CT scan confirmed that she had flat skull height that lacked convexity over the crown area.
A custom skull crown implant was designed to create a more pleasing skull shape with maximal projection of the center of the crown. Its maximal projection was 11 to 12 mms. The see through design images show the difference between her natural skull outline and that of the implant.
Under general anesthesia and in the supine position, a irregular 11cm long scalp incision was made over the top of head. A subperiosteal pocket was widely created. Multiple perfusion holes were placed throughout the implant prior to insertion and closure. The compass marking on the implant allows it to be oriented correctly through the small scalp incision.
Her one year results showed the improvement in the crown height and shape of the top of the head…as well as a happy patient.
The custom crown skull implant is a very satisfying procedure for women. There is a limit as to how much crown height can be obtained based on the limits of how much the scalp can stretch to accommodate the implant.
Highlights:
1) Crown of the head augmentations are the most common form of aesthetic skull augmentation in women.
2) A custom crown skull implant that covers the intersection of the top and back of the head provides the desired location of female ‘bumpit’ head contouring.
3) Most women’s scalps can accommodate in the range of 12 to 14mms of implant thickness.
Dr. Barry Eppley
Indianapolis, Indiana