Understanding the Adult Skull vs. the Infant's Head
The fundamental difference between an infant's skull and an adult's is the presence of cranial sutures—fibrous joints connecting the bony plates of the skull. In newborns, these sutures are not yet fused, allowing the head to be flexible. This is essential for both passing through the birth canal and accommodating the rapid growth of the brain during the first couple of years of life. Positional plagiocephaly, or "flat head syndrome," in infants can often be corrected with repositioning techniques or molding helmets that guide bone growth.
By contrast, an adult's cranial sutures are completely fused, solidifying the skull's shape. This means that massage, exercises, or wearing a helmet are entirely ineffective for changing an adult's bone structure. Any changes to an adult head shape, whether for a flat spot on the back or general asymmetry, can only be achieved through invasive, complex surgical procedures.
Medical and Cosmetic Reasons for Skull Reshaping
While a misshapen head can be a result of congenital conditions like craniosynostosis (premature fusion of sutures), it can also be caused by trauma, previous surgeries (like a craniectomy), or simply aesthetic preference.
Correcting Deformities from Craniosynostosis
Though typically treated in infancy, craniosynostosis can sometimes persist into adulthood or be diagnosed later. This can cause functional issues by restricting brain growth and lead to body image problems due to the misshapen skull. Corrective surgery can address these issues and improve appearance.
Addressing Trauma or Previous Surgeries
Injuries or procedures like craniectomies—where a portion of the skull is removed to relieve pressure on the brain—can leave defects. A cranioplasty is then performed to repair the defect, restoring the skull's integrity and protecting the brain.
Aesthetic Cranial Contouring
For adults unhappy with the natural shape of their head, such as a flat spot on the back (occipital bone), cosmetic reshaping is a possibility. This elective surgery uses various techniques to augment or contour the skull for a more balanced and aesthetically pleasing appearance.
Surgical Solutions for Adult Head Reshaping
The only effective way for an adult to alter the shape of their skull is through surgery, typically performed by craniofacial or neuroplastic surgeons. These procedures, known as cranioplasty or onlay augmentation, use different materials and techniques to achieve the desired shape.
Surgical Materials: Implants and Bone Cement
- Polymethyl Methacrylate (PMMA): Often called bone cement, this biocompatible material has been used in plastic surgery since the 1940s. It can be molded and shaped by the surgeon to fill out a flat area or augment the skull's contour. It bonds smoothly to the existing bone, providing permanent results.
- Polyetheretherketone (PEEK): This durable, biocompatible plastic can be used to create custom-made implants. It is valued for its strength and tissue compatibility.
- Custom Implants: In some cases, a 3D-printed custom implant may be designed based on a patient's CT scan to achieve a precise fit and natural contour.
- Autologous Bone Grafts: In some reconstructive cases, a patient's own bone from another part of the body can be used, though this is not always an option due to risks of infection or bone resorption.
The Skull Reshaping Procedure
Performed under general anesthesia, the surgery involves making an incision, typically in the scalp where it is less visible. The surgeon accesses the skull and applies the chosen material—either filling in hollows with bone cement or securing a custom implant. The material is then shaped and smoothed to achieve the desired contour before the incision is closed with sutures.
Comparison of Surgical vs. Non-Surgical Options
This table highlights the stark differences between available treatments for infants versus the adult reality.
| Feature | Surgical Reshaping (Adult) | Non-Surgical Methods (Infant) |
|---|---|---|
| Target Population | Adults and children with fused sutures | Infants with soft, pliable skulls |
| Effectiveness | Significant, permanent changes possible | Can be highly effective for mild to moderate cases |
| Procedure | Invasive surgery under anesthesia | Repositioning, tummy time, cranial molding helmet |
| Materials | Synthetic implants (PMMA, PEEK), bone grafts | Specialized, custom-fitted helmets |
| Cost | Significant (often over $20k) | Generally less expensive, may have partial insurance coverage |
| Risks | Infection, bleeding, nerve damage, alopecia, aesthetic dissatisfaction | Skin irritation, minor issues |
| Recovery | Typically days or weeks, with hospital stay possible | Continuous wear over several months |
Risks and Considerations of Cranial Surgery
Like any major surgery, cranial reshaping carries risks. It is crucial to have a thorough consultation with a board-certified surgeon to understand the potential complications and manage expectations.
- Aesthetic Outcome: The most common concern is the aesthetic result. Issues like asymmetry or an unsatisfactory shape may occur, with revision surgery needed in 10-15% of cases.
- Infection and Rejection: While rare with modern, biocompatible materials like PMMA, infection or the body's rejection of an implant is a potential risk.
- Bleeding and Nerve Damage: As with any surgical procedure, there is a risk of excessive bleeding or nerve injury.
- Cost and Recovery: The procedure is expensive and requires a period of recovery, potentially including a hospital stay and activity limitations.
For more information on the types of cranioplasty available, the Johns Hopkins Department of Plastic and Reconstructive Surgery is a reputable resource.
Conclusion
In summary, the possibility of reshaping the back of one's head depends entirely on age. For adults with fully fused skulls, only surgical options can achieve a permanent change. Techniques like onlay cranioplasty use bone cement or custom implants to augment and contour the skull, addressing cosmetic preferences or medical deformities from trauma or congenital conditions. While effective, these procedures are complex, carry notable risks, and are expensive. For individuals seeking such a change, a consultation with a qualified craniofacial surgeon is essential to discuss the goals, risks, and realistic outcomes of the procedure.
Important Considerations for Adult Cranial Contouring
Is skull reshaping surgery safe?
Generally, yes, but it carries inherent risks like infection, bleeding, and potential for unsatisfactory aesthetic results, which may require revision. A surgeon's experience and proper evaluation are key to a safe procedure.
How long does recovery take after cranioplasty?
Recovery time can vary, but patients typically stay in the hospital for several days and can resume normal activities within a few weeks, though full healing takes longer.
Are the results of skull reshaping permanent?
Yes, implants and bone cement used in cranioplasty are permanent and will not be absorbed by the body. However, complications can occur that affect the long-term aesthetic outcome.
What are the alternatives to surgical reshaping?
For adults, there are no effective, non-surgical alternatives to permanently change the bone structure of the skull. Minor cosmetic issues can be managed with hairstyles, but this does not alter the underlying shape.
Can a helmet fix a flat spot on an adult's head?
No. Corrective helmets are only effective for infants with pliable skulls and do not work for adults whose skull bones have completely fused.
Can skull reshaping improve neurological function?
In cases where a skull defect affects brain function due to pressure changes, cranioplasty can improve neurological symptoms. However, purely cosmetic reshaping on a structurally normal skull does not alter brain function.
What is the most common reason for skull reshaping in adults?
Beyond trauma, a very common reason for aesthetic skull reshaping is to correct a flat spot on the back of the head (occipital region) for a more rounded appearance.
