Q: Dr. Eppley, Can you tell me the difference between custom skull implants vs bone cement skull augmentation? Which method is safer, how do they compare in costs, and the long term outcomes of both methods. How long can custom implants stay in without complication? Does bone cement break down? Does one method seem to be safer than the other? Infection rates? Future “touch-up” surgeries? Differences in recovery time?
A: In answer to your questions about the two methods of skull augmentation,
1) Custom skull implants can generally be put in through smaller incisions, will have a perfect fit, are assured of having both a smooth contour and a seamless edge transition into the bone due to their computer design.
2) Bone cements with your type of skull augmentation would require a near coronal scalp incision to be adequately placed and allow visual access to get the smoothest contour possible.
3) Neither bone cements nor custom implants will ever break down or need replacing.
4) I have never had an infection with either material so I would not say there is any infectivity difference.
5) Both methods are safe, one is not safer than another. They are just different implant material methods to do the same thing.
6) Custom skull implants are going to have an increased expense over bone cements but the difference is not that significant as the higher cost of fabricating the implants is partially offset by the shorter operative time to place them.
7) There is a slightly less recovery time for custom skull implants because they are placed with a less extensive incision.
Dr. Barry Eppley