Can Custom PEEK Implants Be Used For Head Widening?

Q: Dr. Eppley, I have long been concerned with the shape of my head, specifically feeling that it is too narrow in certain areas. My goal is to achieve a more rounded, symmetrical appearance. Before scheduling an appointment, I would appreciate knowing: Do you perform customized skull implants (using PEEK or PMMA) or bone contouring for aesthetic purposes? What is your typical process for a CT-scan-based evaluation to determine bone thickness? Are there non-surgical options (such as high-density fillers) you recommend for this specific concern?

 A:When it comes to aesthetic skull augmentation I can provide you with the following answers to your questions:

1)  There are no existing injectable fillers that can provide any defective or persistent skull augmentation defects. Only implants can do so.

2) Any type of skull implant is made custom based on the patient’s 3-D CT scan.

3) When it comes to custom skull implant materials the best option remains solid silicone in terms of both tissue tolerance, desired shape and ease of insertion. While they can be made out of PEEK that requires a full bicoronal scalp incision with wide detachment of the scalp from the skull to place it. Most patients are not willing to have that long scalp scar on their head for the sake of having that material. But for those who are so motivated it can certainly be done. PMMA material is not used for custom implants. That is an historic putty like material used in open applications which relies intraoperative shaping for its limited effects.

Dr. Barry Eppley

Plastic Surgeon