Q: Dr, Eppley, I am interested in a cranioplasty procedure.I have a depression on both sides of my skull and the back goes in little also. I have thick hair which covers it up. but, it really bothers me. I’m not sure how my skull go the way it did. but I would like to know if its can be fixed and is it safe. I was also reading about Osteobond from another plastic surgeon. what do you know about that…. thanks.

A: There are two cranioplasty materials to fix skull depressions/contour issues, bone cements (like Osteobond) or a custom silicone skull implant. Having done hundreds of skull augmentations, I have largely moved away from bone cements for many aesthetic skull augmentations due to access and contour issues with them. To properly place bone cement materials, a long scalp incision is needed. This is the only way to place and properly smooth out the intraoperatively applied and shaped bone cements. Putting such bone cements in through small limited incisions is prone to a near 100% irregular contour occurrence. The large the skull augmentation the bigger this contour problem becomes. Custom made skull implants solve these problems by being perfectly smooth (because they are computer designed) and can be placed through smaller incisions than bone cements. While both cranioplasty materials can be successfully used for your described skull shape issues, it is important to understand how and why they are different.

Dr. Barry Eppley
Indianapolis, Indiana