Custom Skull Implant

Q: Dr. Eppley, I am interested in a custom skull implant for my occipital augmentation revision. I came across this company in my research, Xilloc, which uses 3D printing technology along with CT scan image to manufacture patient specific implants using various materials. 

They are on the verge of licensing and releasing a new technology for bone implants called CT-Bone. The patient’s implant is made by printing the material from calcium phosphate. Since calcium phosp is the primary constituent of natural bone, the implant fuses with the existing bone and the body integrates with it just as natural bone bone. The material can also be controlled to exhibit the same porosity as natural bone which may aid in vascularization. The future of cosmetic surgery looks so exciting with this technology. Scientists have also printed human organs like skin, liver and heart with 3d printers using human tissues. Hopefully it will be available in the US market as well.

I really like to have my surgery redone but i have many concerns and expectations that hopefully can be solved with newer and better options. 

-100% biocompatible material

-custom fit

-no use of metal, including titanium screws 

-desired cosmetic correction, smoothness and symmetry 

Will you please look into this, Dr. Eppley. 

With your expertise and skill and open-mindness I think anything is possible. 

Thank you. 

A: I am familiar with many custom skull implant technologies but there are multiple limiting factors. First many such porous hydroxyapatite or calcium phosphate materials tend to be form and less malleable. This creates challenges in surgical placement particularly for the aesthetic skull augmentation patient. A stiffer skull implant material requires a long incision to insert from ear to ear and a complete turn down of the scalp flap. Second, calcium phosphate materials can be more difficult to be made down to a smooth feathered edges. Thus there will be very palpable step offs at the edges of the implant when used as an onlay. This is not an issue for an inlay skull implant but is a huge aesthetic concern in an only skull implant down for aesthetic purposes. Third, the average cost of just the implant alone can be considerable. I don’t the know the exact cost of what this skull implant would be from this company but I would expect it to be more than new thousand dollars.

What you have to appreciate about this technology is that it is understandbly made for inlay bone defects and not primarily for onlay bone augmentations. It is geared for patients who had have skull defects from trauma and neurosurgery and are likely covered by insurance who can absorb the high cost of the implant.. For all of these reasons this may not be a custom skull implant technology for the aesthetic skull augmentation patient. This is a great example of while the technology is great the material chosen for it may limits its application in outer skull contouring/augmentation.

Dr. Barry Eppley

Indianapolis, Indiana