Background: The top of the head usually has a slightly convex shape between the temporal lines that border its sides. This normal superior skull shape can be altered during development and often occurs by how the midline sagittal suture develops and grows. In many cases of undesired superior skull shapes, the sagittal suture line becomes a raised ridge creating a peaked shape to the top of the head.
Rather than a raised ridge the top of the head can also develop without much convexity. It can be relatively flat between the temporal lines creating a more square head shape. While this flatness can be camouflaged by various hairstyles, it can still be very bothersome to some who are so affected.
The best way to create increased convexity to the top of the head and a little bit more height is with the use of a custom skull implant. It does not have to be particularly thick or big to have a noticeable effect. Designed to add skull height between the temporal lines, it extends from behind the frontal hairline back past the crown area down slightly into the occiput.
Case Study: This 44 year-old male disliked the very top of his head, feeling that it was too flat and did not have a nicer more rounded shape. Drawings of his desired head shape change showed that a cap on the top of the head gave the desired effect. Using a 3D CT skull scan, a custom skull implant was designed that added convexity to the top of the head without adding much vertical height.
Under general anesthesia, a small 7 cm long scalp incision was made closer to the back of the head. The custom skull implant had numerous perfusion holes placed throughout it. After the development of the subperiosteal pocket, the implant was inserted in a folded fashion. Once inside the implant was unrolled, positioned as designed and secured with two small titanium microscrews.
A custom skull implant can be designed to create a cap for the top of the head to increase its convexity. This provides a more rounded head shape, a small amount of vertical height and a small amount of additional front to back length.
Highlights:
1) The shape of the top of the skull can be flat, have an irregular shape or be asymmetric.
2) The top of the head can be augmented with a custom skull implant to increase his height or make it have a more convex shape.
3) A custom skull implant to smooth out the top of the head can be inserted through a small scalp incision.
Dr. Barry Eppley
Indianapolis, Indiana