Does it Hurt To Inflate Scalp Expanders?

Q: Dr. Eppley, I have some questions about two stage skull augmentation:

1. How do the scalp expanders work?

2. Does it hurt to have them?

3. How long do they last until permanent implant?

4. Can the scalp expanders be placed anywhere on the skull?

5. Will the scalp expanders alter the appearance of the face(eyes) if used to widen skull? (Not wanting to stretch face)

6. Before any implant is put inside head can I have blueprints of the implant(s) so I can 3d print them and test the look of the implant on my skull?

7. I genuinely believe I look better with a wider skull and have pictures to prove my belief. I add volume to my hair and have been sculpting it for a decade in a way to achieve the desired look of my skull. I want to have as much widening of my skull possible so that’s why I inquire about the scalp expansion.

I would like to discuss in more detail the desired look I would like to achieve with Dr Eppley before any implant models are made. I have pictures if that is necessary. I can also video chat with him again to show him in person if that’s better for him.

A:In answer to your two stage skull augmentation questions:

1) Scalp expanders work like pregnancy….an internal slow pressure on the overlying skin to ultimately allow for a bigger mass underneath it.

2) Beyond their initial surgical placement, no.

3) The usual time period for scalp expansion is between 6 and 12 weeks before the permanent implant is placed depending upon how much scalp expansion is needed. (which is based on the size of the custom skull implant)

4) Yes

5) Unless the scalp expander is placed in the forehead it will not alter the appearance of the face.

6) You are referring to the .STL files of the implant designs. They are available from the manufacturer once the final implant design is completed but not during the various stages of the implant design. Setting an implant model on your head is not all that helpful as it will not sit properly as it is placed on the outside of the scalp as opposed to under the scalp where it will actually reside. Thus it is not a very accurate representation of the final aesthetic result.

7) Many skull augmentation patients, if they have hair, have long demonstrated the benefits of a larger skull base through hair manipulations. Thus I don’t question any patient’s aesthetic desires. I am only focused on what can I achieve in the safest and most effective surgical process. I think in your case for added head width the key question is whether one needs a one vs two stage skull augmentation approach. The best way to figure that out is imaging of your pictures to show the different potential outcomes between the two approaches.

Dr. Barry Eppley

World-Renowned Plastic Surgeon