Is There A Risk Of Hair Loss From A Cranioplasty Procedure?

Q:  Dr. Eppley, I am curious about the use of hydroxyapatite or kryptonite bone cement for the use of building up areas of the cranium that are asymmetrical. Is hair loss something that occurs over the area where either of those two materials would be applied or is hair growth unaffected by having those materials placed onto the cranium?

A: Hair loss is not a potential complication of any cranioplasty procedure. I have been asked this question many times and it is an understandable concern.The blood supply to the scalp is extensive as the scalp is one of, if not the most, vascularized skin structures on the body. More pertinently, the scalp is tremendously thick often being 1.5 to 2 cms in tissue thickness. The hair follicles reside just under the skin in the top layer of the scalp, being in the upper 10% to 20% of its thickness. When raising a scalp flap for any cranioplasty procedure, the entire thickness of the scalp is raised off of the bone. Thus the plane of dissection and flap elevation is far away from where the hair follicles may be injuried. The only risk to hair follicles is in the making of the scalp incision not in the raising of the scalp flap or from the cranioplasty material underneath it. Such limited damage can be avoided by careful angulation of the incision, not using cautery in the upper level of the scalp and in careful scalp incision closure.

Dr. Barry Eppley

Indianapolis, Indiana