Can Custom Skull Implants Cause Cancer?
Q: Dr. Eppley, I have worries about a silicone implant for skull augmentation. First I know it can cause cancer. Also, there will be a void between the implant to the actual skull (what will be filled in there I don’t know, and the feeling of it), probably I will need to replace it after a few years.. (it’s not permanent) and I’m scared having metal (screws) in my head.
Also, I am from the Middle East so monitoring after an implant will be hard from here in case any problem will occur.
Do not use at all bone cement?
A: In answer to your skull augmentation questions:
While I am happy to sue whatever skull implantation material the patient desires, and I have used them all, you have some understandable misconceptions about them which I will clarify.
1) There has never been a case, anywhere in the body, where a smooth SOLID silicone implant has ever caused cancer. You are confusing a solid skull implant with non-solid (gel) breast implants.
2) There is no ‘void’ that occurs between the silicone skull implant and the bone. While true bony integration into the implant does not occur, the small millimeter layer is filled with scar tissue. (known as the capsule)
3) Custom silicone skull implants are permanent, just like bone cement, and never have to be replaced due to any type of device failure. Here again you are likely confusing skull implants with breast implants.
4) The use of metal screws in skull implants is not mandatory. There are only put there as an extra layer of positioning security but are not mandatory. Actually screws are also in bone cements as anchorage points where they are more essential than they are in silicone skull implants.
5) The risk of postoperative issues/complications/need for revisions is actually much higher with bone cements in my experience. They have aesthetic higher risks of irregularities/asymmetries and the need for revisions to manage them.
6) The incision needed for a custom implant vs bone cement skull augmentation is significantly different. Bone cement skull augmentation require a full coronal scalp incision, custom skull implants do not.
Dr. Barry Eppley