Can Mesh Materials Be Used For Aesthetic Skull Augmentation?
Q: Dr. Eppley, What do you think about using long term resorbable meshes for augmentation of flat back head? I have such a condition and I saw a plastic surgeon conducting augmentation using non-absorbable meshes. I would not like to have foreign material in my body for ever but I am really curious about resorbable meshes and their effects in cranioplasty.
A: I could not imagine that a non-resorbable or resorbable meshes would be a very good skull augmentation material for a variety of reasons. Perhaps for very small amounts of ‘spot’ augmentations it may be fine but for the much more common larger surface area skull augmentations that most people desire it would be a far inferior material choice. The key criteria for an aesthetic onlay skull augmentation material is: 1) having a smooth outer surface contour and fine feather edges, 2) easily modified or removed later if the patient is unhappy with the result or desires a change, and 3) able to be placed and properly positioned through small scalp incisions.
There is a corollary to your question and that is the use of mersilene mesh for the chin …which has never become a mainstream technique in chin augmentation surgery.
Lastly non-resorbable meshes are synthetic polymers…an implant material in the skull that may never really absorb. It has never been tested for that implantation site. One should not confuse what happens when such a material is implanted on muscle vs on top of skull bone.
Dr. Barry Eppley