How Soon Could I Return Home After Back of Head Skull Augmentation Surgery?

Q: Dr. Eppley, I am interested in flat back-of-head reshaping / occipital augmentation.

I would like to ask a few questions:

1. What is the estimated total cost for this procedure, including surgeon fee, implant/material, facility fee, anesthesia, CT scan/design, follow-up, and any other related fees?

2. If I travel from Canada to the U.S. for the surgery, how many days should I expect to stay in the area before I can safely fly back?

3. For this procedure, what material would you recommend in my case: my flat head is caused by infant sleep position which my parents intentionally made it this way. Is going to be the custom PEEK implant or PMMA bone cement?

4. Comparing PEEK vs PMMA, which one is more permanent and low maintenance?

5. Since this is back-of-head reshaping, would I need to adjust my sleep position after surgery to protect the result? Long term, can sleeping on the back of the head affect the shape, position, or longevity of the augmentation?

6. What are the common risks or complications for this procedure, especially infection, shifting, uneven contour, scalp thinning, hair loss around the incision, or revision surgery?

A:In answer to your back of the head augmentation questions:

2. You would return home 48 hours after the surgery

3.  and 4.When it comes to skull augmentation the use of PMMA bone cement is now historic and a problematic material we should no longer be used due to its many disadvantages. The far superior material is a solid silicon custom-made skull implant which has feathered edging and can be placed to small scalp incisions.. While PEEK as a satisfactory skull augmentation material it does not have fine feathered edging and requires a bicoronal scalp incision to place it. This makes it an inferior material to that of solid silicone and its use reserved only for those patients are motivated to accept these trade-offs.

5. With back of the head skull augmentation there is no reason to ‘protect’ the results. You can lay on it immediately without any problems affecting the implant or its position.

6. In my extensive experience of over 500 custom skull implants there have been very few significant complications. We do not see hair loss or adverse widening of the scalp scars or hair loss around it. We have yet to see an infection. The most common need for revision is in patients who desire to have an even greater augmentation secondarily.

Dr. Barry Eppley

Plastic Surgeon