How Is An Open Cranioplasty Done?

Q: Dr. Eppley, I have few questions about cranioplasty for my infant son.

1) I’ve read when it comes to cranioplasty, if done correctly and of course by the right surgeon, the scar would be generally “fine” not thick and the hair would eventually regrow on the scar after healthy healing, any truth to this theory?

2) If my recollection serves me correctly, I read when you inserted Kryptonite it was basically sort of like rolling the dice for the most part, because you didn’t EXACTLY know how it was going to turn out. It was basically a wait and see approach. Is it like this with the approach of inserting material in the skull? Or you pretty much have a good general idea by measuring and/or imaging of what it’s possibly going to look like before the surgery?

3) Since my son needs augmenting on the top of his head (right side) to correct/improve the head height differential, and also needs the reconstructing of his parietal bone, can this be done with one incision? Or you need 2 incisions?

4) For cranioplasty the scar will be approx. 4 inches correct (give or take)?

A: You have wisely and correctly interpreted what you have read. All four assumptions are correct.

1) Scalp scars in infants tend to be very fine. I would not always assume that hair will growth through the scar however.

2) Open cranioplasties do not generally have the contour/smoothness issues that are associated with an injectable approach because you can see what you are doing.

3) Only one incision would be needed.

4) The scalp scars are generally not longer than 8 to 10 cms.

Dr. Barry Eppley

Indianapolis, Indiana