How Can My PMMA Bone Cement Skull Augmentation Be Fixed?
Q: Dr. Eppley, I had a skull implant surgery which was performed using 50CC of PMMA bone cement at the back of my head. There is now also a sizeable dent at the top of my head at the site of the incision ( its very hard to see in these photos due to my hair). This dent is palpable and visible to me after i shower and my hair is wet. I assume it’s because of how the PMMA was molded and where it was placed. How can this be fixed?
A: Thank you for sending your pictures. Nothing went ‘wrong’ with your skull augmentation. It is just that the use of PMMA bone cement is a very limiting technique for skull augmentation because of the low volume of cement that can be used and the frequent irregularities of it due to having to insert it and mold it ‘blind’ as it sets. I abandoned this antiquated skull augmentation technique ten years ago due to such inferior results.
By comparison today’s custom skull implants average about 150cc of volume (3X what you have now) with an assured smooth outer surface and good non-palpable edging into the surrounding bone. You would have to have this bone cement removed and replaced with such a custom skull implant for a much improved result.
Dr. Barry Eppley