Custom Skull Implant
Q: Dr. Eppley, I am interested in occipital and forehead augmentation. I am aware of custom forehead and occipital implants but I have several questions for which iIhope to get answers.
1. I do know through research that there are alternative material called PMMA, how does this compare with pre fabricated silicone ?
2. Which one is cost effective?
3. Which one get less side effect and after-problems?
4. If I included my forehead, are we using the same materials?
A: In answer to your additional questions:
1) You are referring to PMMA, a born cement material which is applied like a putty, shaped and than allowed to harden. This is what I used a lot before custom skull implants of which has largely replaced PMMA bone cement in my practice.. A custom skull implant is always better because its shape and exact dimensions are made before surgery. Because it has a preformed shape it is also put in with a smaller incision and less operative time and with a much lower risk of revision due to irregularities or edge transitions.
2) A custom skull implant costs more but PMMA will exceed that cost of a revision surgery is needed due to irregularities or edge transitions.
3) A custom skull implant has much lower revisional surgery risks than PMMA bone cements. It is also much easier ti remove and revise if that need should arise.
4) The issues are the same in the forehead where a custom implant works better than PMMA bone cement.
But the differences between using a custom implant vs. PMMA bone cement may be greater or more similar depending upon the size of the front and back of the head augmentations desired and how much scar length one is willing to tolerate. I would really need to see pictures and do computer imaging of you to get a better idea as to these very important issues.
Dr. Barry Eppley