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Aesthetic skull augmentations are done for both men and women. But there are gender differences in the types of skull augmentations that are done. The most common augmentations done in men are for a flat or asymmetric back of the head, a head shape symptom exposed by short haircuts or a shaved head. The most common skull augmentation done in women, however, is for a larger crown area for a fuller looking head which they can create artificially by hairstyle management.

For women this is the ‘bumpit’ skull augmentation effect, so named because of the variety of commercial products that exist to artificially create it through hair voluminization. Rather than an external temporary effect, a bumpit or crown skull implant is designed to create maximal projection at the junction of the top and back of the head.

Having designed numerous female crown skull implants there are certain design characteristics to them. The maximal point of projection is at a 4 degree angles between the top and back of the head. Most female scalps can stretch to accommodate a 10mm to 14mm projection. But projections greater than that, in the range of 15 to 25mms, will require a first stage scalp expansion. With any amount of increased crown projection it is important to recognize that the footprint or circumferential base of the implant must cover a wider surface area than one would think. Too much projection with an inadequate base will result in an unnaturally looking head shape. The flow of the implant into the surrounding bone should be smooth when viewed from any angle in the implant design.

From the front and back views the implant design must wrap around into the sides or upper temporal regions to have a smooth flow into the surrounding head contours. When one considers how much surface area is necessary to create an implant that looks like a natural part of the head, one realizes that central projection alone belies how much scalp coverage is needed to accommodate the implant volume.

Female bumpit skull implants are very successful at creating crown augmentation but they must be properly designed and have adequate scalp coverage to rival what external devices and hair volumination techniques can accomplish.

Dr. Barry Eppley

Indianapolis, Indiana

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