before and after pics (and wanting opinions, please)

[sproutgirl]

I finally got some side-by-side before and after pictures to compare. Seeing them side by side, I'm surprised by how different Samantha looks overall. We noticed the difference in her forehead right away, but I didn't realize her eyes still looked so different.

Anyway, on the bird's eye view pictures, I would like opinions. Ever since her surgery I have thought that she still looks *much* narrower in the forehead than the back of the head. Maybe it's because the back of her head grew so disproportionately to the front during the first 11 months of her life due to the fused suture, but I guess I thought her forehead would be a little wider. She looks great looking at her face, but whenever I look at the top of her head I see a big difference in width from the front to the back. I have compared her to my other kids, and they seem to have a more gradual "slope" from front to back. I don't see a similarity to their head shape. What do y'all think? The only reason it even concerns me at all is because she had so much pressure before surgery due to not having enough room in her forehead, and me, being the worrywart mom that I am, just worry whether she has enough room for her brain to continue to grow. I don't ever want her to go through the ICP like she had before surgery again. So, do you think her forehead looks narrow? Or does it look like a variation of "normal"?

Thanks in advance for your input. Here are the pics:

http://i69.photobucket.com/albums/i51/sproutgirl2001/beforeandafter4jpg.jpg

http://i69.photobucket.com/albums/i51/sproutgirl2001/beforeandafterbirdseye3jpg.jpg

[Monica]

First of all, I think she looks beautiful. Yes, her eyes have changed, but they may continue to change. I remember it taking forever for the swelling to go completely away, even after I thought it was gone.

The shape of her head from the top - I can definitely see what you are talking about, but I wouldn't be alarmed just yet. Have you been back to see the doctor recently? I know Florence had a 6 month checkup, do you have one scheduled? Just keep taking pictures and watch for changes....

[torichan]

My goodness, she looks great! What a smile! She is beautiful. She looks perfect to me, front on, but yes, I can see your concern from the top view. Did the doctors say that as her brain grows it will reshape the head? I know Emiko is still narrow on the sides but they made cuts to allow for expansion, so as her brain grows and pushes on the sides, her head will continue to widen.

[sproutgirl]

We just saw our surgeons about 2 weeks ago. We saw them 1 month post-op, then 3 months later (which was about 2 weeks ago). We also saw them very briefly one time in between, because Samantha fell off the couch and hit her head, and we went in to see them to make sure nothing got messed up.

Anyway, the first time I asked about this the CFS blew me off, but the NS went into a whole explanation about how the front isn't supposed to be the same width as the back, blah, blah, blah. I understood that, but they didn't seem to understand that I think her forehead is really narrow, and they didn't really look at her forehead. The next time, the CFS did take more time to look and seemed to understand what my concern was. I told him that I had expected her forehead to be wider. He said he thinks this is just going to be her head shape, and he thinks her forehead couldn't really go any wider or else it would look weird and wouldn't like up right with her eye sockets, etc. He thinks it is just fine. I do think they did a good job on her head, I just think her forehead looks really narrow.

You know how it is, you find yourself examining your child's head way more than you should. And I find myself comparing her head to her sisters' heads every time I bathe them.

We don't go back to the surgeons until a year from now, so I will just have to wait and see how her head grows in the meantime. Like I said, I just worry about her having enough room to grow. Her soft spot has already closed in, so everything is fusing in her skull, and I don't know enough to know how it grows and develops from this point. I do know that her forehead has smoothed out and the frontal bossing she had on one side has gotten much better since right after surgery.

I'm glad to know that I'm not crazy for seeing what I see in her forehead/head shape. ;-) I guess I"ll just give it a year and see how it grows. Maybe I"ll post pics again when we get closer to that time.

She still fusses a lot (though nothing like before surgery, when it was constant, and it was clear she was in pain), so some days I worry about whether they got it all fixed, or if her forehead is still too narrow, etc. She is getting more and more happy, so I think everything is going to turn out just fine. But still, it's hard not to overthink it and worry at times.

[fitmomof2ae]

Wow, I agree that Samantha looks great from the front! However, I see the narrow sides that you mention. I would check with the Dr at your follow-up appt.

It took an entire yr for my son's head to grow following his surgery. You daughter is still young, so you may see the shape change as her head grows. My son had the barrel staves mentioned above. They helped with widening as the head grew.

[sproutgirl]

And thanks for the comments and compliments. I thought she was beautiful before, and I think she is beautiful now. I can't wait to see what she looks like 6 months or a year from now. :-)

[sproutgirl]

Wow, I agree that Samantha looks great from the front! However, I see the narrow sides that you mention. I would check with the Dr at your follow-up appt.

It took an entire yr for my son's head to grow following his surgery. You daughter is still young, so you may see the shape change as her head grows. My son had the barrel staves mentioned above. They helped with widening as the head grew.

That is encouraging, to know that her head might still be growing and changing. Guess I'll wait a while and see what happens. We don't go back to the surgeon for another year, anyway, so I guess I'll *have* to wait anyway.

I appreciate all the input. It helps to have others weigh in. I've been meaning to post these pics forever, it just took me this long to get them side by side for comparison.

[G2sMama]

I was going to say pretty much the same as everyone else. I think she's absolutely gorgeous. Hopefully she's not having any ICP issues, and it's just a matter of stage-in-life for her right now. :hugg to you!!

[jjmc123]

She looks fantastic from the front. I see what you mean from the top of the head, but maybe the surgeon is right that if he made it any wider it would look strange? The front view looks so right, I would think a larger forehead would be out of place.

[Nezzy]

I personally think she looks great. Did the CFS over correct? As long as he over corrected i wouldn't worry too much about it.

[Mindy]

Hi,
I was going to ask the same question as Heather. She looks great from the front as he corrected her pinching at the temples nicely. And I agree that he probably couldn't do any more expanding in the forehead without it afffected her eye placement. She has really nicely spaced eyes and if he did anymore, they would likekly look too far apart. I do see the concern with the front of her head being more narrow than the back. My son's mild metopic head looks the same way (although he hasn't had surgery), but I still think its within the realm of normal. Being that she still has alot of growth to do (the skull grows the most in the first 2-2 1/2 years of life), they normally overcorrect so that it doesn't revert back to the pre-op shape as that is what it tends to do.

As for your other question about how the skull continues to grow if the sutures are closed, I'm not sure about a skull that had a CVR, but normally, the skull expands at the sutures. The metopic is the only one that closes in infancy and the others don't fuse until the 2nd decade of life. The skull also gets bigger by laying down more bone.

I would keep asking your questions until you feel satisfied with what they tell you. Your daughter is beautiful!!

[NCmommy]

She is so cute! I'm not experienced with the narrowing in the front, but I do see your concerns. Have you called the doctor just to ask?

[sproutgirl]

Thanks so much for all the responses. I really do appreciate it. Sorry it took me so long to get back to this thread. I'm glad I asked y'all this question, because at the very least you have given me the confidence to keep asking our doctors if I still see a problem when we go back for our one-year follow-up.


She looks fantastic from the front. I see what you mean from the top of the head, but maybe the surgeon is right that if he made it any wider it would look strange? The front view looks so right, I would think a larger forehead would be out of place.

Thanks. That is true, and does help me put my mind at ease.


Hopefully she's not having any ICP issues, and it's just a matter of stage-in-life for her right now. :hugg to you!! Yes, hopefully so. The week I wrote this was a tough week, but we are having more and more great weeks, so I'm thinking it can't be ICP. But when I compare her head size and then think about her fussiness...well, it has caused me a little bit of worry.



I personally think she looks great. Did the CFS over correct? As long as he over corrected i wouldn't worry too much about it.

I *think* he did, but I'm not positive. I think before the surgery he had talked about overcorrecting and letting her head "grow into" it. But I can't remember for sure, and it wasn't mentioned after surgery. Basically what he has told me after the surgery is that they open up the sutures so that her head has the opportunity to grow on its own and do "what it should."



Hi,
As for your other question about how the skull continues to grow if the sutures are closed, I'm not sure about a skull that had a CVR, but normally, the skull expands at the sutures. The metopic is the only one that closes in infancy and the others don't fuse until the 2nd decade of life. The skull also gets bigger by laying down more bone.

I would keep asking your questions until you feel satisfied with what they tell you. Your daughter is beautiful!!

I did not know that about the sutures closing in the 2nd decade of life. I had thought everything closed up around 18-24 months. Thanks for the info.

And thanks for the encouragement to keep on until I get answers. Sometimes I feel too timid and give in, then end up wondering.


She is so cute! I'm not experienced with the narrowing in the front, but I do see your concerns. Have you called the doctor just to ask?

Thank you. :-) I asked the doctor at our appointment in March. When I had asked at our post-op appointment, he just blew me off. He gave a much better explanation when I asked in March, and he thinks it is a variation of normal; however, he hasn't really looked very closely at her head shape. No one else in our family has a head shape like hers, though her surgeon said he thinks she has my head shape. That I don't know about. I still think she looks really narrow from a bird's-eye view, which is why I wanted y'alls opinion. I guess I will just wait and see what it looks like in a year, and if I'm still concerned then, I may ask y'alls opinions again at that time before we see the doctor if I'm still concerned. ;-)

Thanks again for all the input! Y'all are SO helpful! :-)