Treatments for Metopic Synostosis (Trigonocephaly) in Children

Boston Children's Hospital has been a worldwide innovator in diagnosing and treating children with metopic synostosis and all types of craniosynostosis for decades. Clinicians in our Departments of Neurosurgery and Plastic and Oral Surgery have extensive experience in treating all forms and degrees of the condition.

We use minimally invasive techniques — medical and surgical procedures that use small incisions and miniaturized cameras and tools — whenever we can. In fact, Boston Children's is a global leader in creating and refining new surgical approaches.

Treatment: Not always necessary

A child with mild metopic synostosis may have no symptoms beyond a noticeable ridge down the middle of his forehead. In these cases, doctors may decide no medical treatment is needed.


Many children with moderate to severe metopic synostosis will require surgical intervention.

Surgery for metopic synostosis:

  • is designed to correct deformities in the facial and skull bones
  • often works best in children who are less than 1 year old, since the bones are still soft and pliable, making them easier to manipulate
  • may be recommended in much younger infants, including newborns, depending on the severity of their symptoms
  • can also be performed in older children (although the older the child, the more complex the surgery)
  • is usually complete after a single surgery (but in some cases, may need to be repeated over time, depending on the seriousness of the condition)

Before the operation, your child's surgeon will:

  • explain the reasons to consider surgery
  • explain the steps involved in the operation
  • review aftercare instructions, including warning signs of possible complications

During surgery, the surgeon and treatment team will:

  • in the case of minimally invasive surgery, use endoscopy — a long, thin tube with an accompanying light and camera—to release the sutures that are abnormally fused
  • in the case of reconstructive surgery, reposition the skull bones to allow for normal growth and development

Monitoring and follow-up

After surgery, your child:

  • will stay in the hospital for one to five days
  • may have visible swelling for a few days to a few weeks
  • may need to wear a dressing covering her head, protecting the incision site from contamination and infection
  • will need to return for check-ups and evaluations to measure how well the skull, facial bones, and brain are developing

Coping and support

When your child has metopic synostosis, your family may have many concerns and questions. Not only are you focused on meeting all of your child's medical needs: You are also grappling with a significant emotional and psychological toll that can affect every member of the family.

In addition to the clinical information offered on this page, Boston Children's has several other resources designed to give your family comfort, support and guidance:

Patient and family resources at Boston Children's

Boston Children's Behavioral Medicine Clinic helps children who are being treated on an outpatient basis at the hospital — as well as their families — understand and cope with their feelings about:

  • being sick
  • facing uncomfortable procedures
  • handling pain
  • taking medication
  • preparing for surgery
  • changes in friendships and family relationships
  • managing school while dealing with an illness
  • grief and loss

The Experience Journal was designed by Boston Children's psychiatrist-in-chief David DeMaso, MD, and members of his team. This online collection features thoughts, reflections and advice from kids and caregivers about living with medical conditions and going through treatment.

Boston Children's Psychiatry Consultation Service is comprised of expert and compassionate pediatric psychologists, psychiatrists, social workers and other mental health professionals who understand the unique circumstances of hospitalized children and their families. The team provides several services, including:

  • short-term therapy for children admitted to one of our inpatient units
  • parent and sibling consultations
  • teaching healthy coping skills for the whole family
  • educating members of the medical treatment team about the relationship between physical illness and psychological distress
  • talking to your child about her condition
  • preparing for surgery and hospitalization
  • supporting siblings
  • taking care of yourself during your child's illness
  • adjusting to life after treatment

Boston Children's Hale Family Center for Families is dedicated to helping families locate the information and resources they need to better understand their child's particular condition and take part in their care. All patients, families, and health professionals are welcome to use the Center's services at no extra cost. The center is open Monday through Friday from 8 a.m. to 7 p.m. and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.

The Boston Children's Hospital chaplaincy is a source of spiritual support for parents and family members. Our program includes nearly a dozen clergy members—representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian, and United Church of Christ traditions — who will listen to you, pray with you, and help you observe your own faith practices during your child's treatment.

Global Services is a dedicated resource for patients and families from countries outside the United States. The center can provide assistance with everything from reviewing medical records to setting up appointments and locating lodging. Contact the center by phone at +1-617-355-5209 or via e-mail at

Helpful links

Please note that neither Boston Children's Hospital nor the Craniofacial Anomalies Program at Boston Children's unreservedly endorses all of the information found at the sites listed below. These links are provided as a resource.

 General information for Children's patients and families

 Read our comprehensive guide.