Introduction:
Skull reshaping is called skull augmentation, contouring, and cranioplasty. It is often executed for cosmetic augmentation or rectifying any skull deformities. For example, many patients desire a more oblong-shaped skull; this procedure can correct the shape and size of the head.
Aesthetic skull reshaping is a type of plastic surgery that uses craniofacial techniques to alter the shape of the head to address aesthetic concerns. It can include contouring, augmenting, and reshaping various parts of the head, such as the brow bones, back of the head, and sides. Unlike traditional skull surgery, which is done inside the skull, this type of surgery is done on the outside of the skull and can provide solutions for head shape concerns previously thought to be permanent.
What Is Head Reshaping?
Skull reshaping, also known as skull contouring or back-of-head augmentation, is a surgical procedure used to alter the shape of the skull. The procedure may address skull abnormalities or achieve a more desired skull shape. Before surgery, patients must thoroughly consult the surgeon to discuss their needs and expectations.
Another reason for skull reshaping is craniosynostosis, in which the joints of an infant's skull fuse prematurely, altering the natural growth pattern of the skull, which can lead to the skull growing too large and insufficient space for the brain to develop properly, causing intracranial pressure, sleep issues, and potential developmental delays.
Thus, a temporal reduction procedure may be performed, which involves shortening or removing part of the temporalis muscle and thinning the skull to reduce its width. In addition, in cases where there is a defect in the skull due to a previous craniotomy, a cranioplasty procedure may be performed using either the patient's bone or a custom skull implant to reconstruct the skull.
What Are Custom Skull Implants?
Custom skull implants may be an option for patients with large and complex skull defects. This procedure involves using a 3D (dimensional) scan of the patient to create a custom-fit implant designed to fill in any uneven areas of the skull. The implant is typically made from a biocompatible material, such as HTR or PEEK, widely used in this surgery.
HTR stands for Hydroxyapatite-Tricalcium Phosphate, a biocompatible ceramic material that can be used in skull implants. PEEK stands for Polyetheretherketone, a thermoplastic polymer widely used in medical and dental applications. Both materials are considered biocompatible, meaning the body cannot reject them and can be used in skull implants. They are widely used in this type of surgery because they are strong, lightweight, and can be shaped and formed to perfectly fit the patient's skull. In addition, these custom implants can augment the skull from the forehead to the back of the head. They can be inserted through remote incisions due to their flexibility, allowing for a more precise and targeted reshaping of the skull, providing a more accurate and natural-looking result.
What Are the Different Types of Cranioplasty?
There are different techniques used in skull reconstruction surgery, including using an augmentation cranioplasty to add bone to a deficient area for contouring or a reduction cranioplasty to remove excess bone from a protruding area for contouring.
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Autologous Reconstruction - The surgeon will utilize the patient's bone to repair the defect. This method, known as an autologous bone graft, has advantages such as the reduced risk of infection and extrusion. However, it also has drawbacks, such as uneven resorption, difficulty in reshaping, and potential complications at the donor site. Examples of autologous bone grafts are split calvarial bone grafts, rib grafts, and iliac crest bone grafts.
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Alloplastic Reconstruction - The surgeon will utilize synthetic materials to repair the defect as an alternative to autologous bone grafts. These materials have been created to overcome the limitations of using a patient's bone. The most commonly used synthetic materials are titanium mesh, calcium phosphate products, polymethylmethacrylate (PMMA), and custom-made polyether ether ketone patient-specific implants (PEEK).
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Reduction Cranioplasty - Patients may have abnormal bony growths or spurs, often present from birth, that can appear anywhere on the skull, including the forehead, vertex, or occiput. Treatment for these growths is carried out by reduction cranioplasty, a straightforward procedure. Depending on the size of the area affected, the bony protuberances are removed through an incision in the hairline using tools such as osteotomes or burrs. This results in a scar that is hidden on the scalp.
How Preoperative Selection for Skull Reshaping Surgery Procedure Made?
In the case of craniosynostosis in a newborn, that patient may be an ideal candidate for skull reshaping. This condition is characterized by the premature fusion of the sutures in the skull, which can lead to an abnormal head shape. Additionally, if you have irregularities in the shape of your skull, such as flattening, bumps, ridges, or an unusually wide or narrow head, skull reshaping may be an appropriate option. This procedure can correct these issues and create a more symmetrical and balanced appearance.
Does Skull Reshaping Surgery Need a Long Recovery Time?
The recovery from skull reshaping surgery may vary depending on the scope of the operation. Typically, patients can resume their normal activities shortly after the swelling and bruising have dissipated. Mostly, the surgery does not impose any restrictions on physical activity post-surgery, and patients are allowed to shower immediately. However, the doctor emphasizes that recovery is subjective and depends on the patient's condition.
Conclusion:
Head reshaping, also known as skull reshaping or cranioplasty, is a surgical procedure that can correct abnormal head shapes or skull irregularities. This procedure can be performed on adults and children and addresses conditions such as craniosynostosis and skull shape abnormalities. The procedure can be done using either the patient's bone or synthetic materials.
Recovery from skull reshaping surgery varies depending on the extent of the procedure. Still, most patients can return to normal activities shortly after the swelling and bruising subside. It is significant to discuss this with a skilled plastic surgeon with experience in skull reshaping to determine if this procedure is appropriate.
