How Long Should A Scalp Expander Be In Place Before Getting A Custom Skull Implant?

Q: Dr. Eppley, You say that it is possible to start the custom skull implant process after the scalp expander stage, only you told me that the scalp expander must stay in place for 6 weeks and that the average time for the implant process is 13 weeks. The scalp expander will have to stay in place for 13 weeks under the scalp. Is this not a problem?

Also regarding the scalp expander device, does it imply any particular conduct in daily life? Stop doing sports? Avoiding certain activities or situations? Can I sleep normally?

I would also like to know, when the patient comes for the scalp expander, can you examine our head and discuss together the best correction to make? And make a mold of my skull, for example?

Concerning the fixation of the implant, you talk about small screws, can this lead to cranial lesions? How do you fix them? I have seen several of your videos where you insert the cranial implant but I have not seen any where you fix it with the screws. Is there a place where I can see them? 

A: In answer to your scalp expander questions:

1) Scalp expanders can stay in literally forever. The time of 6 weeks for scalp expansion is the absolute minimum time…longer is always better.

2) I wold avoid contact sports while the scalp expander is there. You sleep in whatever position is comfortable.

3) The 3D CT scan can be used to make an exact 3D skull model if one so desires.

4) Almost every skull implant I have ever done had the use of small screws. They do not cause cranial ‘lesions’.

Dr. Barry Eppley

Indianapolis, Indiana