At What Age Can Injectable Kryptonite Cranioplasty Be Done?

Q: You have mentioned that there are some risk with smoothness issues with injectable Kryptonite cranioplasty. If the cement were to not feel smooth once set, could it still be smoothed out later? Is there a more appropriate age to do the kryptonite procedure? Is 4 years old too young to have it done?

A: Like all plagiocephalies, there are numerous other skull deformities as well. Your son is no different is that he has right occipital protrusion as well as his left occipital flattening. The back of his head is asymmetric as a result of both and not just the flattening alone. But since it is only practical through a limited incision approach to do augmentation, all that can be done is to build up the flatter left side.

 During surgery, the molding of the material is done externally until it feels smooth, But since you can’t see it, it is impossible to know absolutely for sure. One can tell what the final result will be about 6 to 8 weeks after surgery when the swelling has subsided and, most importantly, the scalp skin has shrunk down and become adhered to the material and skull bone. Then you can feel the final result with certainty. If any irregularities or edges can be felt, secondary smoothing can be done through the same limited incision using shaping rasps just like we use in smoothing the nasal bones during rhinoplasty.

 The age in which to consider the procedure is entirely open to debate and is more psychological than chronological. One can have the procedure when they are certain the skull is no longer substantially changing and the parents think that it is in the best interest of the child from a self-image and social interaction standpoint.

Dr. Barry Eppley

Indianapolis, Indiana