Q: Dr. Eppley, I had brain surgery for a tumor over 10 years ago. This left me with a scar in my scalp which initially was not a problem. As I have gotton older and more hair has fallen out, the scar and some depressions along it has become more noticable. I thnk if the holes were filled in it would nto be so obvious. I was trying to determine if I would be a candidate for using injectable fillers to fill holes and creases left by the surgery. I have attached some pictures for your review.
A: What you have, as you know, are the skull depressions from the craniotomy burr holes from your original surgery. They have sunken in due to lack of full-thickness skull bone support from underneath the scalp. These are quite common from craniotomy surgery. Leveling them out is very straightforward by building up the smoothness of the underlying skull bone. I would not use injectable Kryptonite in these cases because the scalp tissue is quite stuck down into the hole and needs to be released from the burr hole and then built up and leveled with bone cement. This is much easier to do and will create a smoother result by opening up a small portion of the scar directly over the depressions and placing hydroxyapatite bone cement directly into the underlying bone defects. This is a ‘spot’ form of cranioplasty. This is not much more invasive than an injection approach and is more likely to get rid of the scalp depressions with a smooth transition into the normal surrounding bone and scalp.
Dr. Barry Eppley