How Do You Know When To Stop When Doing Skull Reductions?

Q: Dr. Eppley, While doing the skull reductio n bone burring, Dr. Eppley mentioned that he can tell when he needs to stop. How exactly can he tell? I understand there are 3 layers in the skull, and only the outer layer (outer table) can be reduced. Is the entire outer table removed during a reduction? If not, how much is removed, and what is the factor that dictates when you must stop?

A: In skull reduction surgery the outer table of the skull is removed until one gets close to the diploic space which starts to bleed…now it is time to stop.

Dr. Barry Eppley

World-Renowned Plastic Surgeon