Skull Implant Revision

Q: Dr. Eppley, I’d like to get an injected skull implant revision, but I have a few concerns/questions.

1) You mentioned removing and replacing the implant as being the preferred method. What size scalp incision would that take? What material would you use to replace it?

2) You recommended not doing the burring only. Is it because of the potential unfavorable results or is it another reason? How long would that incision be?

I’m nervous to go under the knife again after the results of the last skull implant procedure. My main concern is the resulting scar length and width.


A: While I don’t recall what the material that was injected (t would be very helpful to see the operative note from that procedure), I assume it was bone cement or PMMA. The ability to give it a better contour by contouring what is already there is nil. That is why it is better to remove and replace it by:

1) 3 cms scalp incision over it. Such scalp scars heal really well with minimal width. The aesthetic result of such scalp scars is all about how they made and then closed with protection of the hair follcicles.

2) Probably replace with new bone cement because it can be better contoured under direct vision. But this would depend on the size of the defect of which is not known to me yet.

Dr. Barry Eppley

Indianapolis, Indiana