What Is A Special Design Skull Implant?

Q: Dr. Eppley, I would like to proceed with the “Special Design Back of Head Skull Implant” option. However, I do have a follow-up question:

How would this pre-designed implant be adjusted to fit the unique shape of my head, considering that it was not created based on my specific CT data? Additionally, would my preferences regarding the shape—which I illustrated during my consultation with Dr. Eppley using the images I shared—still be realized with this option? Finally, is there any risk that the implant might not fit properly?

I apologize for the slight confusion and for asking so many questions, but it is important for me to have more clarity to ensure I am making the best possible decision. I truly appreciate your patience and understanding.

A: The only reasons a patient choses a Special Design (SD) implant is 1) economics (it costs less) and 2) I think what I have available to use will work reasonably well. What counts in any skull implant is the outer contour change, not an intimate fit underneath.  Any discrepancy between the implant and the bone will get filled in with scar tissue. The implant sits  in place with screws and is stiff enough that it does not flex. What really makes the SD implant possible in your case is the wide open coronal incisional approach where adapting the implant to the shape of the skull can be seen under direct vision. The SD concept does not work as well as when a more traditional ‘blinded’ limited incision approach is used as is done in the vast majority of skull augmentation cases.

That being said the way to obviate any of the SD implant concerns is to just do a true custom design. You choose the SD approach not because it is better but because it lowers the cost of the surgery somewhat.

Dr. Barry Eppley

World-Renowned Plastic Surgeon