Adult Plagiocephaly Surgery: Is It Right for You? Find Out!

Beyond the more commonly discussed developmental conditions, there are instances where anatomical characteristics, once thought to be static, manifest challenges throughout adulthood.

Reshaping Realities: Understanding Adult Plagiocephaly Beyond Aesthetics

When discussing head shape abnormalities, the focus often defaults to infants. However, a significant yet less recognized condition, adult plagiocephaly, presents unique challenges that extend far beyond simple cosmetic concerns. This persistent skull deformity can profoundly impact an individual’s quality of life.

What is Adult Plagiocephaly?

Adult plagiocephaly refers to a persistent skull deformity characterized by an asymmetrical or flattened head shape, which has carried over from childhood or developed due to specific circumstances in adulthood. Unlike the soft, malleable skulls of infants, an adult skull, once formed, retains its structural rigidity. This means that any asymmetry or flattening observed in an adult is a permanent feature of their bone structure, defining the distinct contour of their head. It’s not merely a surface irregularity but a fundamental deviation in the skull’s architecture.

Distinguishing Adult from Infantile Plagiocephaly

It is crucial to differentiate adult plagiocephaly from its more commonly discussed infantile counterpart. While both involve an asymmetrical head shape, the underlying conditions and potential for non-surgical correction are vastly different:

• Infantile Plagiocephaly: Typically occurs in babies due to external pressures on a soft, developing skull (e.g., spending too much time on their back). It is often correctable with repositioning techniques, physical therapy, or cranial orthotic helmets, especially when addressed early.
• Adult Plagiocephaly: Represents a fixed, structural deformity of the fully ossified adult skull. This rigidity means the bones are no longer pliable, and the condition cannot be corrected through repositioning or external pressure devices. Instead, it is a permanent aspect of the individual’s anatomy, often requiring more complex interventions if correction is desired.

The True Impact: Beyond Just Appearance

While the visible asymmetry of adult plagiocephaly is its most obvious feature, the condition’s impact delves much deeper than purely cosmetic concerns. For many adults, the physical manifestation leads to a cascade of both physical and psychological issues that can significantly diminish their overall well-being.

Physical Manifestations

Beyond the aesthetic, some individuals with adult plagiocephaly may experience:

• Ill-fitting Headwear: Helmets, hats, and glasses may not sit correctly, leading to discomfort or an inability to use protective gear effectively.
• Hair Styling Difficulties: The uneven skull shape can make certain hairstyles challenging or reveal the asymmetry, contributing to self-consciousness.
• Secondary Musculoskeletal Issues: While not directly caused by the skull shape, sometimes associated conditions or compensatory postures might lead to neck pain, jaw issues, or headaches, though direct causality is still debated and studied.

Psychological & Social Repercussions

Perhaps the most profound impacts of adult plagiocephaly are psychological and social:

• Self-Esteem and Body Image: Living with a visible, often unique, physical difference can severely affect an individual’s self-perception and confidence.
• Social Anxiety and Avoidance: Fear of judgment, stares, or insensitive comments can lead to social withdrawal, avoidance of public situations, or even depression. Individuals might go to great lengths to conceal their condition, impacting their daily lives and interactions.
• Emotional Distress: Feelings of frustration, embarrassment, and isolation are common, particularly for those who feel their concerns are dismissed as merely "cosmetic" by others who don’t understand the depth of their distress.

Exploring Corrective Paths: The Role of Cranial Surgery

Given the fixed nature of the adult skull, non-surgical interventions are ineffective for correcting adult plagiocephaly. For adults seeking correction, the path is significantly more complex, often involving specialized medical evaluation. While it is a major decision with inherent risks and considerations, cranial surgery exists as a potential option. This type of reconstructive surgery aims to reshape the skull to achieve greater symmetry and improve overall head contour, offering a pathway for individuals to address the physical and, by extension, many of the psychological burdens of the condition.

Understanding these various facets of adult plagiocephaly naturally leads us to explore its origins and how we precisely identify its presence.

While understanding adult plagiocephaly as more than just a cosmetic issue is crucial, the next step involves delving into why these skull asymmetries occur in the first place and how medical professionals accurately pinpoint their origins.

Beyond the Surface: Unraveling the True Origins of Adult Plagiocephaly

Adult plagiocephaly, or a persistent asymmetry of the skull, can stem from a variety of factors. Pinpointing the exact cause is fundamental for accurate diagnosis and effective treatment planning. While some cases are a lingering reminder of early development, others signal a more complex underlying condition requiring specialized attention.

Positional Plagiocephaly: A Lingering Legacy from Infancy

The most common form of plagiocephaly originates in infancy and is known as positional plagiocephaly. This occurs when an infant’s head repeatedly rests in the same position, often due to factors like torticollis (a condition causing a twisted neck) or preferential head turning, leading to a flattening of one side of the skull. While many cases resolve naturally or with early intervention (like repositioning or helmet therapy), some persist into adulthood.

For adults, this means that the skull deformity present is a long-standing issue from childhood that was either unnoticed, untreated, or simply didn’t fully correct itself. Although primarily a cosmetic concern in adulthood, the associated head shape can sometimes contribute to issues like ill-fitting headwear or, in rare cases, jaw misalignment if severe.

Craniosynostosis: A Deeper Concern Requiring Expert Evaluation

A significantly more serious underlying cause of skull deformity, which can manifest as plagiocephaly, is craniosynostosis. This condition involves the premature fusion of one or more cranial sutures – the fibrous joints that connect the bones of the skull and allow for brain growth during infancy and childhood. When these sutures close too early, the skull cannot expand normally, leading to:

• Abnormal Skull Shape: The specific shape depends on which sutures are affected.
• Potential for Increased Intracranial Pressure: In some cases, especially when multiple sutures are involved, the restricted skull growth can put pressure on the developing brain.
• Developmental Issues: If untreated, increased pressure can lead to developmental delays, vision problems, or other neurological complications, though these are more severe in childhood.
• Reconstructive Challenges: Surgical correction in adulthood can be more complex due to bone maturation.

It is critical to differentiate craniosynostosis from positional plagiocephaly, as the implications and required treatments are vastly different. An expert evaluation is essential for accurate diagnosis.

To clarify the distinction between these two primary causes of adult plagiocephaly, the following table highlights their key characteristics:

Feature	Positional Plagiocephaly (Adult)	Craniosynostosis (Adult)
Underlying Cause	External forces/positioning during infancy; no bone fusion.	Premature fusion of one or more cranial sutures.
Skull Shape	Generally a parallelogram-shaped head; often one-sided flattening at the back of the head, with forehead bulging on the same side. Ear may be pushed forward.	Highly variable, depends on fused suture(s); often more severe and complex asymmetry, potentially affecting forehead, midface, or back of head.
Severity	Typically cosmetic; rarely associated with functional issues.	Can range from cosmetic to potentially impacting brain growth and neurological function if severe and untreated.
Associated Risks	Minimal to none in adulthood; possibly jaw asymmetry in severe cases.	Potential for increased intracranial pressure, developmental issues (if untreated in childhood), and more complex reconstructive needs.
Primary Management	Often observation; if treatment desired, bone reshaping via surgery.	Surgical intervention (cranial surgery) is typically required to release fused sutures and reshape the skull.

Charting the Course: The Diagnostic Journey

Accurate diagnosis is paramount to understanding the specific nature of an adult’s skull deformity and planning the most appropriate course of action.

Initial Consultation with Experts

The diagnostic process typically begins with a consultation with a specialist who has expertise in craniofacial conditions. This often includes a Plastic Surgeon (Craniofacial) or a Neurosurgeon. During this initial visit, the specialist will:

• Take a detailed medical history, including any known history of plagiocephaly in infancy or related conditions.
• Conduct a thorough physical examination of the head and face, carefully assessing the skull shape, symmetry, and any palpable abnormalities.
• Discuss the patient’s specific concerns and aesthetic goals.

The Power of Advanced Imaging

To definitively diagnose the cause and accurately assess the skull deformity, modern medical imaging plays a crucial role:

• Computed Tomography (CT Scan): A CT scan provides highly detailed cross-sectional images of bone structures. This is invaluable for:
  • Suture Assessment: It clearly shows the cranial sutures, allowing specialists to determine if any have prematurely fused, which is the hallmark of craniosynostosis.
  • Bone Density and Thickness: Provides information about the bone itself.
  • Underlying Structures: Can reveal any other intracranial abnormalities, though this is less common in isolated plagiocephaly.
• 3D Cranial Imaging: Derived from CT scan data, 3D cranial imaging creates a comprehensive three-dimensional model of the skull. This technology is incredibly beneficial because it allows the surgical team to:
  • Visualize the Deformity: See the skull deformity from all angles, providing a complete picture of its extent and characteristics.
  • Accurate Measurements: Take precise measurements of the skull’s asymmetry and volume.
  • Surgical Planning: Critically, it enables detailed pre-operative planning, allowing surgeons to virtually simulate corrections and determine the most effective surgical approach before even entering the operating room.

This advanced imaging is essential not only for confirming the diagnosis of positional plagiocephaly versus craniosynostosis but also for guiding any potential reconstructive efforts, ensuring the most precise and effective treatment strategy.

With a clear understanding of the underlying cause and the extent of the deformity, the focus then shifts to the potential pathways for correction and whether surgical intervention is truly the only solution available.

Once the intricate causes of adult plagiocephaly have been thoroughly identified and precisely diagnosed, the focus naturally shifts to exploring viable pathways toward correction and improved quality of life.

Reclaiming Your Form: Unpacking the Role of Cranial Surgery in Adult Plagiocephaly

For adults living with plagiocephaly, particularly those with significant cranial asymmetry, the journey to a more symmetrical head shape often leads to a comprehensive discussion about surgical intervention. Unlike the often effective non-surgical options available for infants, adult cases present a unique set of challenges and considerations, primarily necessitating corrective surgery to achieve meaningful aesthetic and, at times, functional improvements.

The Definitive Path: Corrective Cranial Surgery (Cranioplasty)

When adult plagiocephaly presents with noticeable deformation, the primary and most effective treatment is corrective cranial surgery, commonly referred to as a cranioplasty. This intricate procedure aims to reshape the skull, addressing both the underlying bone structure and the external contours to restore a more balanced and aesthetically pleasing head shape. It is a highly specialized undertaking, focusing on precise reconstruction to achieve lasting results.

A Collaborative Endeavor: Neurosurgeon and Craniofacial Plastic Surgeon

The complexity of adult cranioplasty often necessitates a collaborative approach, bringing together two distinct but complementary surgical specializations. A Neurosurgeon plays a critical role in ensuring the safety of the brain and surrounding neural structures during any manipulation or reshaping of the skull. Their expertise is paramount for procedures involving bone removal, modification, or the placement of implants near delicate brain tissue. Concurrently, a Craniofacial Plastic Surgeon focuses on the aesthetic and functional reconstruction of the skull and facial bones. Their specialized knowledge ensures that the redesigned cranial contours are not only symmetrical but also natural-looking, achieving optimal aesthetic outcomes while maintaining facial harmony. This dual expertise guarantees that both the functional integrity and the aesthetic goals of the patient are met with the highest level of precision and care.

Precision and Personalization: Custom Cranial Implants

A significant advancement in adult cranioplasty involves the use of custom cranial implants. These bespoke implants are meticulously designed using 3D Cranial Imaging data (such as CT scans), which provides an exact topographical map of the patient’s skull. This detailed imaging allows surgeons to create an implant that perfectly matches the missing or depressed areas of the skull, or to augment existing areas to achieve greater symmetry and a desired head shape. The custom-fit nature of these implants ensures precision, reduces surgical time, and leads to highly predictable and aesthetically superior results compared to older, more generalized reconstruction techniques.

Non-Surgical Avenues: A Limited Landscape for Adults

While the concept of non-surgical correction, such as helmet therapy, is a well-established and highly effective treatment for infants with plagiocephaly, it is extremely limited and generally ineffective for adults. The fundamental difference lies in skeletal maturity. An infant’s skull bones are still pliable and actively growing, allowing external pressure from a custom helmet to gently guide growth and reshape the head. In adults, the cranial bones are fully fused and hardened. Once the skull has matured, external pressure alone cannot significantly alter its shape. Therefore, for adults seeking meaningful correction of established plagiocephaly, non-surgical interventions offer little to no aesthetic benefit. Any "treatment" focused on position changes or physical therapy might address secondary issues like neck stiffness, but not the cranial asymmetry itself.

Comparing Approaches: Surgical vs. Non-Surgical for Adult Plagiocephaly

Understanding the stark differences between available approaches for adults is crucial for managing expectations and making informed decisions.

Feature	Surgical Approach (Cranioplasty/Implants)	Non-Surgical Approach (Adults)
Effectiveness	High: Can achieve significant, lasting correction and symmetry.	Extremely Limited/Minimal: Does not effectively reshape the adult skull; no significant aesthetic improvement.
Ideal Candidates	Adults with moderate to severe plagiocephaly seeking definitive aesthetic correction, or addressing functional concerns (e.g., ill-fitting headgear).	Adults with extremely mild, almost imperceptible asymmetry, or those seeking management of secondary symptoms (e.g., neck pain) unrelated to skull shape correction.
Key Considerations	Invasive procedure, requires anesthesia, carries surgical risks, involves a recovery period, definitive results, often covered by insurance if functionally indicated or severely disfiguring.	Non-invasive, no recovery time related to cranial shape, no significant aesthetic change, focuses on symptom management rather than correction of shape.

Understanding these potential pathways is the first step; the next involves a critical look at the practical realities and potential challenges of surgical intervention.

While the discussion of cranial surgery as a potential treatment path for plagiocephaly opens up avenues for significant correction, it’s equally vital to approach this decision with a thorough understanding of the journey involved.

Beyond the Operating Room Doors: Navigating the Surgical Journey and Its Aftermath

Opting for surgical intervention is a profound decision, and it’s essential to have a clear, realistic picture of what the process entails—from the initial steps in the operating room to the crucial recovery phase that follows. This transparency is fundamental to true informed consent.

The Surgical Procedure: Anesthesia and Duration

Before any corrective work begins, your child will undergo general anesthesia. This critical medical procedure involves administering medications that induce a deep, controlled state of unconsciousness, ensuring they experience no pain, awareness, or memory of the surgery. A highly skilled anesthesiologist and their team will continuously monitor your child’s vital signs throughout the procedure, adjusting medications as needed to maintain their safety and comfort.

Cranial reconstructive surgery for plagiocephaly is a complex and precise undertaking. While exact times can vary based on the specific technique used and the individual case, these procedures typically last several hours, often ranging from three to six hours. This duration accounts for the meticulous reshaping and repositioning of the skull bones required to achieve the desired correction.

Understanding the Potential Risks

No surgical procedure is without risk, and cranial surgery for plagiocephaly is no exception. Before proceeding, your surgical team will engage in a detailed discussion about these potential complications, ensuring you are fully informed and have the opportunity to ask questions. This comprehensive dialogue is a cornerstone of informed consent. Key potential risks include:

• Infection: Despite rigorous sterile techniques, there is always a small risk of infection at the surgical site or within the bone. This may require antibiotic treatment or, in rare cases, further surgical intervention.
• Bleeding: As with any surgery involving bone and tissue manipulation, there is a risk of bleeding during or after the procedure. In some cases, a blood transfusion may be necessary.
• Implant Complications: If implants (such as resorbable plates or screws) are used to stabilize the reshaped skull, there is a rare chance of issues like migration, malposition, or requiring removal if they cause problems.
• Anesthesia-Related Issues: While modern anesthesia is very safe, potential risks include adverse reactions to medications, respiratory problems, or other systemic complications. Your anesthesiologist will discuss these specific risks with you.
• Incomplete Correction or Need for Revision: In some instances, the initial surgery may not achieve the desired degree of correction, or new growth patterns may necessitate future revision surgery.
• Cerebrospinal Fluid (CSF) Leak: A rare complication where fluid surrounding the brain and spinal cord leaks through an opening in the skull, potentially leading to infection or other issues.

The Road to Recovery: What to Expect

The recovery period following cranial surgery is a critical phase of healing and rehabilitation. It begins with an initial hospital stay, typically lasting several days, where your child will be closely monitored for pain management, wound care, and any signs of complications. As they transition home, the recovery journey continues for weeks and months, involving gradual healing and adherence to specific activity restrictions.

Here is a general timeline outlining typical milestones and restrictions:

Timeframe	Expected Milestones	Activity Restrictions
Week 1 (Post-Op)	– Hospital stay (typically 3-7 days) – Initial pain management – Significant swelling and bruising – Close monitoring of vital signs and surgical site	– Strict rest and limited movement – No strenuous activity, lifting, or bending – Head support when holding/moving – Sponge baths only, keeping surgical site dry
Month 1 (Post-Op)	– Home recovery – Swelling and bruising gradually diminish – Reduced pain, managed with oral medication – First follow-up appointments – Begin light, supervised activity	– Avoid direct impact to the head – No contact sports or rough play – No swimming or submerging head in water – Supervision during all activities – Follow surgeon’s guidance on head-wearing items
3-6 Months (Post-Op)	– Continued healing and bone fusion – Significant improvement in head shape – Return to most normal daily activities – Ongoing follow-up appointments to monitor progress	– Gradual return to all normal activities, including most sports (with surgeon’s clearance) – Continue to avoid high-impact head trauma until fully cleared – Final assessment of results

Note: This is a general timeline. Individual recovery can vary based on the child’s age, overall health, and the specifics of the surgery.

Crucial for Success: Post-operative Care

Adhering strictly to all post-operative care instructions provided by your surgical team is paramount for a successful outcome and to minimize complications. This includes:

• Medication Management: Administering prescribed pain relief, antibiotics, or other medications as directed.
• Wound Care: Following specific instructions for cleaning and dressing the surgical incision to prevent infection.
• Activity Restrictions: Conscientiously limiting your child’s activities as advised, particularly concerning head trauma and strenuous play, to protect the healing skull.
• Follow-up Appointments: Attending all scheduled post-operative visits with the surgical team to monitor healing, assess progress, and address any concerns.
• Nutritional Support: Ensuring your child receives adequate nutrition to support bone healing and overall recovery.

Understanding these realities of surgical risks, the recovery process, and the importance of diligent post-operative care empowers you to make an informed decision, laying the groundwork for the next steps in planning this significant medical journey.

Even after understanding the physical challenges and recovery involved, the journey toward corrective surgery often presents its most significant non-medical obstacle: the financial landscape.

The Price of Transformation: Costs, Coverage, and Your Crucial Decision

Navigating the complexities of medical financing, especially within the United States Healthcare System, can feel like a labyrinth. For adult plagiocephaly surgery, the financial implications are substantial and often dictate the viability of the procedure for many patients.

Understanding the Cost of Medical Procedures

The estimated Cost of Medical Procedures for adult plagiocephaly surgery can vary widely based on several factors, including the surgeon’s fees, anesthesiologist’s fees, facility charges (hospital or outpatient surgical center), pre-operative tests, and post-operative care. While exact figures are difficult to pinpoint without a specific treatment plan, patients should anticipate a significant financial commitment.

• Surgeon’s Fees: These can range from $5,000 to $15,000 or more, depending on the complexity of the case and the surgeon’s experience and location.
• Anesthesia Fees: Typically, these are calculated based on the length of the surgery and can add several thousand dollars to the total.
• Facility Charges: Hospital or surgical center costs often comprise the largest portion, potentially ranging from $10,000 to $25,000+, covering operating room time, nursing staff, and recovery room services.
• Ancillary Costs: This includes pre-surgical consultations, diagnostic imaging (e.g., CT scans), lab work, and post-operative medications or physical therapy, which can add several hundred to a few thousand dollars.

Collectively, an adult plagiocephaly surgery can easily range from $20,000 to upwards of $40,000 or more out-of-pocket without insurance coverage, making Health Insurance (United States) a critical component of the decision-making process.

Navigating Health Insurance (United States): The Cosmetic vs. Medical Dilemma

One of the most significant challenges in securing coverage for adult plagiocephaly surgery is the frequent classification of the procedure as a Cosmetic Concern by insurance providers. While the aesthetic improvement is often a key motivator for patients, many individuals experience functional issues such as headaches, temporomandibular joint (TMJ) dysfunction, visual field disturbances, or ill-fitting protective headwear due to their cranial asymmetry.

The distinction between cosmetic and medically necessary is paramount:

• Cosmetic Concern: If the primary documented reason for surgery is aesthetic improvement without significant functional impairment, insurance companies are highly likely to deny coverage.
• Medically Necessary: For insurance to consider coverage, there must be clear medical documentation demonstrating functional impairment directly attributable to the plagiocephaly. This requires thorough diagnostic workups, reports from specialists (e.g., neurologists, optometrists, dentists), and a strong letter of medical necessity from the operating surgeon.

The Role of the United States Healthcare System: Pre-Authorizations and Appeals

Engaging with your insurance provider early is crucial. The process typically involves:

1. Pre-authorization/Pre-certification: Before any procedure, your surgeon’s office will submit a request to your insurance company, detailing the proposed surgery, medical necessity, and expected costs. This initial step is vital for getting an "OK" from your insurer that they might cover the procedure.
2. Documentation is Key: The success of a pre-authorization often hinges on comprehensive medical records, including:
   • Diagnosis codes (ICD-10) that align with medical necessity.
   • Procedure codes (CPT) for the planned surgery.
   • Clinical notes detailing symptoms and functional impairments.
   • Photographs and imaging studies (e.g., CT scans with cephalometric measurements).
   • Letters of medical necessity from all treating physicians.
3. Appeals Process: If a pre-authorization is denied, you have the right to appeal the decision. This often involves multiple levels:
   • First-Level Appeal: Usually, a written request with additional documentation and a detailed explanation of why the surgery is medically necessary.
   • Second-Level Appeal (Internal Review): If the first appeal is denied, it goes to a different review team within the insurance company.
   • External Review: If internal appeals are exhausted, you can request an independent external review by a third party, often through your state’s Department of Insurance. This is a critical step where an unbiased medical professional reviews your case.

This entire process can be lengthy and requires persistent advocacy from both the patient and the surgical team.

Empowering Your Patient Decision-Making

Given the significant Surgical Risks, the financial burden, and the lengthy recovery period, informed Patient Decision-Making is paramount. It involves a comprehensive evaluation of several factors:

• Potential Benefits:
  • Relief from functional symptoms (headaches, TMJ pain, vision issues).
  • Improved self-esteem and psychological well-being.
  • Enhanced facial symmetry and aesthetic appearance.
• Surgical Risks: Revisit the risks discussed in the previous section, including infection, nerve damage, anesthesia complications, and unsatisfactory aesthetic results.
• Costs: Fully understand your out-of-pocket expenses, including deductibles, co-pays, co-insurance, and potential costs for uncovered services.
• Recovery Period: Be prepared for the physical limitations, discomfort, and time away from work or daily activities that recovery entails.

Ultimately, the decision rests on whether the potential benefits outweigh the combined risks, financial strain, and commitment required for recovery. Open and honest discussions with your surgeon, your family, and your insurance provider are essential to make an informed choice that aligns with your personal goals and resources.

To aid in this complex process, here is a checklist of questions to pose to your insurance provider regarding coverage for Cranial Surgery:

Questions to Ask Your Insurance Provider Regarding Cranial Surgery Coverage	Yes/No/N/A	Notes/Details
Is this procedure (CPT code: ____) covered under my plan?
Is a pre-authorization required? If so, what is the timeline and process?
What criteria does my plan use to determine if cranial surgery is "medically necessary" vs. "cosmetic"?
What specific documentation (e.g., diagnostic reports, letters of medical necessity) is required for pre-authorization?
What is my deductible, and how much of it has been met?
What is my out-of-pocket maximum, and how much of it has been met?
What percentage of the "allowed amount" will my plan cover for an in-network surgeon/facility?
What are my co-pay and co-insurance amounts for surgical procedures?
Are there any specific exclusions for congenital conditions or adult cranial reconstruction?
What is the process for appealing a denied pre-authorization or claim?
Do I need separate pre-authorizations for the surgeon, anesthesiologist, and facility?
Are there any in-network surgeons or facilities specialized in this type of surgery?
What is the expected out-of-pocket cost if the procedure is deemed cosmetic?
Who is my dedicated case manager or contact person for this complex claim?

Understanding these financial and logistical elements is crucial for preparing to make an informed decision and confidently moving forward.

Navigating the path to correcting Adult Plagiocephaly is a significant undertaking, but it is a journey you can approach with confidence. We’ve established that this is a treatable, though complex, condition where an accurate diagnosis is the critical first step. While corrective cranial surgery is a major procedure with real risks and a demanding recovery, it offers a definitive solution for those seeking change.

The most crucial element is making a fully informed decision that aligns with your personal goals. Your empowerment comes from understanding the procedure, its costs, and the importance of a skilled craniofacial team. If you are ready to explore your options further, the next step is clear: schedule a consultation with a board-certified Plastic Surgeon (Craniofacial) or Neurosurgeon. A personalized evaluation is the only way to get the answers you need to move forward.