How Can My Forehead Reconstruction Be Fixed?

Q: Dr. Eppley, I need a skull graft operation (frontal cranioplasty) or frontal cranial bone reshaping.

I had previously been in an accident that led to the fracture of the frontal skull bones. I had the skull patched with a 3D print (peek), but it became higher than the original skull bone, so I needed to either sculpt or file the existing impression so that it was equal to the frontal skull bones, or replace the current impression.

A: In theory the existing frontal skull implant should be able to be burred down. But because it is a PEEK material this is an incredibly firm material so its intraoperative reduction can noi be assured.

Given its custom design and the obvious over correction/protrusion I am suspicious that this was originally a partial thickness bone defect. This makes the use of a material like PEEK ill advised since it simply can not be made very thin. It is more indicated in full thickness skull defect swhich requite thicker implant thicknesses.

I would need to see the implant design file which will show the original skull contour deformity so I can advise a more appropriate frontal skull contouring method.  (either bone cements or a different implant material.

Dr. Barry Eppley

World-Renowned Plastic Surgeon