What Is The Difference Between PMMA Bone Cement and Custom Skull Implants For Head Augmentation?

Q: Dr. Eppley, Just a question…what’s the different between solid silicone to PMMA for augmentation of the head?

A: For aesthetic onlay skull augmentation PMMA vs Custom Silicone implants are the  two options which have the  following properties:

PMMA Bone Cement

  • moldable putty created in surgery which sets into a rigid plastic material in 10 minutes
  • once set it is unchangeable in form
  • must be shaped blindly once placed under the scalp thropugh small scalp incisions…as a a result prone to asymmetries and edge irregularities
  • controlled shaping of the material can only be done through an open coronal scalp incision
  • can only be placed on bone, can not cross the bony temporal line onto the muscle
  • limited skull augmentation effects (60ccs or less in volume)
  • can not be revised secondarily, must be fractured and removed
  • lower material cost

Custom Skull Implant

  • preformed shape by 3D custom design process
  • can be modified intraoperatively if needed I(rare)
  • can be placed on bone as well as muscle permitting large surface areas of coverage
  •  more significant skull augmentation effects (100cc to 300cc volumes)
  • easily removed, modified and/or replaced
  • higher material cost

Dr. Barry Eppley

World-Renowned Plastic Surgeon