Skull Implant Replacement for Larger Size

Q: Dr. Eppley, I am interested in a skull implant replacement., I have a question regarding a skull implant and the incision site. I had a silicone skull implant placed via a coronal incision last year. Unfortunately it hasn’t provided the desired aesthetic outcome for me. I am wanting it redone, I don’t feel it was big enough or the shape I want. However, I don’t want it to be placed via a coronal incision again, the scar and resultant hair loss is too noticeable. My question is,  are you able to go in and remove and replace from a site lower on my head? Thank you.

A: I am not sure of the reason that a skull implant needs to be placed by a coronal incision as I have never found that necessary. But that issue aside, once you have the coronal incision there is no reason to use another incision as that just makes it a lot more difficult that it needs to be particularly with a larger implant. (you have to break through the scar capsule to expand the implant base) There should be no reason that hair loss occurs around a coronal incision and that undoubtably is a function of technique not an expected part of making a coronal incision. The second time you can also do a scar revision and make it look a lot better.

Usually one can double the size of the original skull implant the second time in a skull implant replacement procedure. But I would need to see the original design drawings of the first implant to provide a more qualified answer in that regard.

Dr. Barry Eppley
Indianapolis, Indiana