How Can I Fill Ii The Dent Over The Temporal Area That A Bone Cement Skull Augmentation Did Not Reach?

Q: Dr. Eppley, I have some skull augmentation questions after getting a PMMA bone cement procedure.

1) What is a solid silicone skull implant material you use ?

2) Do you have a picture i can see to have a better understanding ?

3) How can it be attached, screws or glue?

4 Is it going to be stable when pressure applied to it like playing soccer or doing any activities can affect like if i fall is it going to stay stable ?

5) The other point will be infection possibility and risk

6) Is it doable with PMMA bone cement?

7) Finally for the most part is done i would say 20 percent left has a dent . since on left side my temporal muscle is big I don’t want to add on the top of it .roughly 2 to 2.5 inch length triangle part needs to filled outward ( convex ) like a segment of galic or orange shape to make it smoothly rounded . I have to wait few more months in order to make sure there is no swellings but I will forward you some pictures to let you estimate . Thanks in advance for your help .

A:Thank you for your inquiry and sending your pictures. When it comes to augmenting the triangular area that you have outlined this can only be effectively evaluated and done by 3-D planning with the custom implant placement. This is the only way to optimize the amount of augmentation, cover the area needed without over or under correction and blending it in to the underlying PMMA bone cement. The first step is always to go to the 3-D CT scan to make all of these evaluations. This will allow the determination as to whether the implant will need to be custom-made, which is optimal, or for the sake of economics be interested in fashioning it from other materials.

Regardless of how the implant is made it will remain structurally and positionally stable, it will feel like bone, is secured to the area with screw fixation, and is not going to prohibit you from ever doing any type of physical activity.

Dr. Barry Eppley

Plastic Surgeon