What Is The Best Implant Material For Forehead and Back Of The Head Augmentation?
Q: Dr. Eppley, I have few question regarding forehead augmentation and back of the head augmentation. I would appreciate your kind answers to each of them one by one.
1. Which procedure is more durable, bone cement or implant?
2. Can you please tell the advantages and disadvantages of each?
3. Is it possible that bone cement is filled without cutting the scalp, so we fill the scalp by injection three to four time(interval of ten days) and it may increase the whole head size?Because i fear of cutting scalp and tissue expander.
4. Is bone cement strong enough like skull bone?
5. Which procedure do you recommend?
A: For forehead and occipital (back of the head) augmentation, there are two basic materials that be used…bone cement and preformed implants. In answer to your questions:
- Both material are equally durable. Neither can degrade, be broken down or will ever need to be replaced because they ‘wear out’.
- Each material type has its own unique advantages and disadvantages. Bone cements must be mixed, applied and shaped during surgery thus taking more operative time to do. Preformed implants are made before surgery off of a 3-D CT scan of the patient’s skull. By computer design they provide the best and most symmetrical augmentation with the least risk of any irregularities at the implant-bone transition areas. They can also be done with less operative time. From a cost standpoint, they are roughly equal.
- With either approach, a scalp incision is needed. There is not injectable cranioplasty technique for this size of skull augmentation areas. There is no need for a tissue expander with your dual augmentation.
- The resistance to fracture is roughly equal between PMMA bone cements and skull bone.
- I find both procedures can make for successful skull augmentations. The choice between the two is a matter of personal preference and which one sounds better for each patient. Both type of forehead and skull implants can be done very successfully.
Dr. Barry Eppley