Q: Dr. Eppley, I want to have a normal shaped-head. I have neurosurgery two years ago and the bone flap had to be taken out and frozen due to brain swelling afterwards. It was put back in at a second operation but as it healed it became very uneven. I have dents and visible screwheads throughout my entire forehead. One of the screws also became loose and had to be removed later. Also my forehead is so narrow and looks like an alien. I just want to look close to what I used to before the accident, a more normal shape head with noindents and bumps sticking out. You can see in my forehead photos how unusual my forehead looks.
A: The re-implantation of skull bone flaps, while necessary, is often fraught with bony resorption and irregularities. In addition, the metal hardware used to place it often become visible or loose as you have experienced. The good news is that vast improvement can be obtained by an onlay cranioplasty. Using your original scalp incision, the bone can be re-exposed, all existing metal hardware removed and the entire forehead and skull area covered and built up in a smooth and symmetrical fashion using any of the several available cranioplasty materials. This is a highly successful procedure that is not associated with any of your prior problems with bone flap replacement surgery.
Dr. Barry Eppley