Are Cranioplasty Materials Permanent And Do They Break Down Or Leak Over Time?

Q: Dr. Eppley, I’m interested in cranioplasty augmentationsurgery but have a few more questions. 

1. Is this correction permanent meaning is it reversible? is it expected to last a lifetime?

2. You mention PMMA is harder than hydroxyapatite, will i feel the difference? 

3. Is the hardness of hydroxyapatite similar to real bone? Will it feel more natural to me?

4. Will I experience foreign body sensation with this “implant”

5.  I’m not an expert on the anatomy of the skull but i’ve read that there are gaps between the bones of the skull even when they are fused. how will this type of correction subtle dynamics of contraction and expansion of my skull bones, once a material like hydroxyapetite is plastered onto them? 

6. Is there potential for leakage/breakage of material and if so what are the health, carcinogenic, or risks.

7. Is there risk of allergic reaction to the material?

Thank you for the work that you do.

A: In answer to your questions:

1) All cranioplasty materials are permanent,  meaning that they do not degrade, break down, and never need to be replaced because they wear out. They are, however, fairly easily removed so they are completely reversible.

2) There is no external feeling difference between PMMA and HA. Their biomechanical differences are largely that of laboratory testing.

3) There are no feel differences between PMMA and HA and they will feel both natural and just like your own bone.

4) Patients do not report that they feel like they have a skull implant in place. It feels just like bone.

5) There are no gaps between adult skull plates. That is an in utero and neonatal phenomenon.

6) Cranioplasty materials are fully polymerized and do not break down, leak, or degrade over time. There are no long-term health or carcinogenic risks.

7) While infection can occur from their surgical placement, there is no known risk of an allergic reaction to HA and very rare risk to PMMA.

Dr. Barry Eppley

Indianapolis, Indiana