Q: Dr. Eppley, I have a skull implant question. In your experience how do these two materials perform in terms of edge transitions (edge of implant to the skull)? Is there a noticeable step off from the implants onto the skull on a shaved head?
A: In the shaved or bald male head, there is always a concern about a visible transition of a skull implant to the bone. Eventually any less than smooth transition will be seen no matter how thick the scalp is. PEEK implants can not be made with a feather edge to them because of the way they are manufactured. (machined) Furthermore they were never designed to be used an an onlay and the company will probably not make them knowing that it is to be used as an onlay since they are only FDA-approved as inlay skull implants for defects. Conversely silicone skull imlpants can be made with a fine feather edge by virtue of the way they are manufactured. (poured and oulled off of a mold)
In short, a silicone skull implant offers the best material capability for the smoothest implant to bone transition. In the exposed scalp patient a skull implant needs to have a virtual feather edge at its perimeter.
Dr. Barry Eppley