Artificial cranial deformation, also called head flattening or head binding, is a practice where the shape of a human skull is changed intentionally. This is done by applying pressure to a child's skull while it is still soft and growing. Different shapes, such as flat, long (using wood), round (using cloth), and cone-shaped, are chosen by various cultures.

This process usually begins when a child is about one month old and lasts for around six months. It is performed during early infancy because the skull is most flexible at this stage, making it easier to reshape.

History

People have been intentionally changing the shape of their skulls before written history began. This practice was common in many cultures across the world, both in the past and in some places today, such as Vanuatu.

Some of the earliest examples were once thought to include Neanderthals and early humans from about 9,000 BCE in Iraq. For a time, scientists believed Neanderthal skulls were shaped intentionally. However, later research in 1999 showed that this was not the case. Scientists now think that elongated skulls found among ancient people in Southwest Asia were likely shaped intentionally.

The first written record of this practice comes from the Greek doctor Hippocrates around 400 BCE. He described a group called the Macrocephali, or Long-heads, who shaped their babies’ skulls.

In the Old World, the Yuezhi people, who later created the Kushan Empire, brought the practice to regions like Bactria and Sogdiana. Artwork from this time shows men with elongated skulls, such as a Kushan prince in Khalchayan.

Alchon kings are known for their long skulls, which were shaped intentionally. An archaeologist named Cameron Petrie wrote that Alchon kings and some groups in Europe, like the Huns, practiced this. Their coins show clearly elongated skulls, which helped them stand out from other groups, such as the Kidarites. These skulls replaced crowns used by the Sasanian Empire on coins. This practice was also found among other groups in the steppes, like the Huns, and in Europe, where the Huns introduced it.

In the Pontic steppe and parts of Europe, the Huns, including the Proto-Bulgarians, practiced similar skull shaping. The Alans also did this.

During Late Antiquity (300–600 CE), East Germanic tribes ruled by the Huns, such as the Gepids, Ostrogoths, Heruli, Rugii, and Burgundians, adopted the custom. Among the Lombards, Burgundians, and Thuringians, this practice was done mainly by women.

In western Germanic tribes, artificial skull shaping was rarely found.

Three women with elongated skulls were found in Viking-era burials in Gotland, Sweden, around the 11th century. Researchers think these women may not have been native to the island, as Gotland was known for trading with other cultures.

In the 20th century, some European cultures, like in France, western Russia, the Caucasus, and among the Sámi in Scandinavia, still practiced skull shaping. Reasons for this varied, including beauty standards and old beliefs about the brain. In Toulouse, France, this practice was linked to a medical method called "bandeau," where babies’ heads were wrapped to protect them. Some people believed this made the children less intelligent.

In the Americas, the Maya, Inca, and some Native American tribes practiced skull shaping. In North America, tribes like the Chinookan and Choctaw did this. The Bitterroot Salish, also called the Flathead Indians, were often thought to do this. However, the Salish people say this belief was based on a hand gesture in their sign language. Other tribes, like the Choctaw, Chehalis, and Nooksack, used cradleboards to flatten infants’ heads.

The Lucayan people of the Bahamas and the Taínos of the Caribbean also practiced skull shaping.

In the Philippines, the Visayans and Bikolano people flattened the foreheads and sometimes the back of the heads before colonization. This was common in areas like Samar and Tablas. Tools like rods called "tangad," plates called "sipit," and padded boards called "saop" were used. These were tied to a baby’s forehead with bandages. Spanish priest Diego Bobadilla first recorded this in 1604. He noted that people in the central Philippines placed babies’ heads between boards to flatten them, seeing this as a mark of beauty. This practice was also done by nobility as a symbol of status, though it is unclear if it was limited to nobles.

People with flattened foreheads were called "tinangad," while those with unmodified skulls were called "ondo," meaning "packed tightly." People with flattened backs of the head were called "puyak," but it is not certain if this was intentional. Other practices linked to this custom included blackened teeth, tattoos, genital piercings, circumcision, and ear plugs. Similar customs were found among groups in Sarawak, Sulawesi, and Sumatra.

In 1896, Friedrich Ratzel reported that skull shaping was found in places like Tahiti, Samoa, Hawaii, and the Paumotu group. It was most common on Mallicollo (now Malakula, Vanuatu), where skulls were flattened extremely. This practice was also done on New Britain in Papua New Guinea until the 1930s.

In Africa, the Mangbetu people shaped their skulls by wrapping babies’ heads tightly with cloth called "Limpombo." This practice declined in the 1950s.

In Japan, on the island of Tanegashima, from the 3rd to 7th century, a group may have bound babies’ skulls to flatten them.

Methods and types

Deformation often starts shortly after a baby is born and continues for a few years until the desired shape is achieved or the child stops using the device.

There is no single, widely accepted system for classifying cranial deformations. Many scientists have created their own systems, but they have not agreed on one system that applies to all types observed. An example is the system developed by E. V. Zhirov in the 1940s. He identified three main types of artificial cranial deformation—round, fronto-occipital, and sagittal—based on observations in Europe and Asia.

Motivations and theories

According to one modern theory, cranial deformation was likely done to show group membership or to indicate a person's social position. These reasons may have been important in Maya society, where the practice aimed to create a skull shape that looked more attractive or connected to valued cultural qualities. For example, in the Na'ahai-speaking area of Tomman Island and the south-southwestern Malakulan (Australasia), people with elongated heads were believed to be more intelligent, of higher status, and closer to the world of spirits.

Historically, many theories have been proposed to explain why these practices occurred.

It has also been suggested that cranial deformation began as an effort to copy groups where an elongated head shape was natural. Some ancient Egyptian skulls are known to have been naturally elongated, and this trait may have been inherited within families. For example, Rivero and Tschudi described an Inca mummy containing a fetus with an elongated skull. They wrote:

"The same head shape was present in unborn children. We have strong proof of this in the sight of a fetus found inside the womb of a mummy of a pregnant woman, discovered in a cave near Tarma. This fetus is currently in our collection. Professor d'Outrepont, a well-known expert in obstetrics, confirmed the fetus was about seven months old. Based on the shape of the skull, it belonged to the Huancas tribe. We include a drawing of this evidence to challenge the idea that mechanical pressure was the only cause of the head shape seen in the Peruvian race."

P. F. Bellamy made a similar observation about two elongated infant skulls discovered by a "Captain Blankley" and given to the Museum of the Devon and Cornwall Natural History Society in 1838. Bellamy noted that the skulls belonged to a female and male infant, "one of which was not more than a few months old, and the other could not be much more than one year old." He wrote:

"It is clear from the shape of these skulls that they are similar to those in the Museum of the College of Surgeons in London, called Titicacans. Many believe these adult skulls were shaped by pressure, but Dr. Graves argued that a close examination showed their shape was not caused by artificial pressure. This view is supported by the fact that the unusual shape is as noticeable in the child as in the adult, and even more so in the younger child. This is further supported by the long size of the skull bones, the position of the occipital bone (which is not forced upward), the lack of signs of pressure (such as raised areas or protrusions on the sides), and the absence of tools or devices that could have caused such changes."

Health effects

Studies of Peruvian skulls show that there is no real difference in brain size between skulls that were intentionally shaped and those that were not.