What is Aesthetic skull reshaping surgery?
Abnormal skull shapes can be a great source of anxiety for some patient. By skull reshaping, we are referring to a craniofacial aesthetic procedure that addresses abnormal skull shapes by removing areas of excess bone deposition, adding alloplastic material to areas that are deficient on bone content, or using implants to reshape the skull with the view to giving it a normal and acceptable appearance
What are the characteristics of a normal skull?
The skull is made up of several bones – frontal, temporal, parietal, pterygoid, sphenoid and occipital. The temporal, pterygoid and sphenoid bones are in pairs, whereas the frontal, parietal and occipital bones are single.
The cephalic index, which is a ratio of the width of the skull divided by the length, is used as a rough guide to assess what is considered normal. This ratio, in a normal population, lies somewhere between 75% and 80%. A normal appearing skull also looks symmetrical, from front to back on both sides.
What are some of the abnormal skull types?
Abnormal skull shapes can be the consequence of accidents, surgery, or simply premature fusion or development of some of the cranial sutures. The common abnormal skull shapes include scaphocephaly, plagiocephaly and brachycephaly. Scaphocephaly occurs when the sagittal suture fuses prematurely, resulting in an abnormally long skull. Plagiocephaly is when one side of the occipital bone fails to develop normally, resulting in flattening on one side. Brachycephaly is when both sides of the occipital fail to develop normally, resulting in flattening of the occiput
What are some of the indications for skull reshaping?
In children of up to six months of age, skull reshaping may be performed for functional or aesthetic reasons. Skull reshaping may be performed surgically or via the use of helmets. In adults, skull reshaping by reshaping of the skull bones is not possible due to the inherent risks of blood loss. As such, skull reshaping in adults is mainly performed via the use of custom-made implants. Common indications would be correction of abnormal skull shapes post craniectomies or purely for aesthetic reasons.
Preparation for skull reshaping sugery
The first step in skull reshaping surgery is to have an initial consultation with the lead surgeon, Mr Ivo Gwanmesia. Consultations are face to face but for out of town patients, consultations can be virtual. The next step is obtaining a cone beam CT scan which the surgeon will organise. Data from the scan is used to fabricate the skull implants. We prefer that our patients are healthy and are free from medical comorbidities. We also prefer patients who are non-smokers, or have ceased smoking for at least 6 weeks prior to the surgery
How is skull reshaping surgery performed?
Skull reshaping surgery in adults is mainly for aesthetic reasons. It is achieved mainly by the use of custom made implants. The implants are made from either silicon or Polyetheretherketone (PEEK). The surgery is performed under general anaesthesia and access to the skull is achieved through incisions on the scalp. Depending on the extent of the incisions, drains may be required and patients may be required to stay overnight in the hospital.
Aftercare for skull reshaping surgery
Patients may go home the same day after surgery or spend one night at the hospital. An overhead bandage is kept in place for the first week after surgery. Review appointments are at one week, six weeks, three months and six months after surgery. It is advisable to avoid any strenuous activities for the first couple of weeks after surgery. A comprehensive aftercare document is provided to every patient undergoing skull reshaping surgery.
Risks of skull reshaping surgery
There are always risks associated with surgery. The most common ones include bleeding, hematoma formation, unfavourable scar formation, alopecia, inadequate correction of the deformity, dissatisfaction with the outcome and the need for revision surgery. Our team will address any complications at the earliest possible time
What other skull anomalies do we treat?
Patients can also present with areas of excessive bony growths or spurs that are usually congenital. These are known as osteomas, and are generally benign. Treatment usually involves burring down the areas of excessive bony growths or removal with an osteotome.
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Skull Reshaping (Craniofacial) Surgery FAQ
The cost for skull reshaping surgery will vary depending on the extent of the patient’s specific needs. For those requiring removal of small benign growths on the skull, the cost will start from about £4000. For those patients requiring custom made implants, the cost will range from £15000 to £25000
At the time of surgery, an incision will need to be made on the scalp to gain access to the skull. These incisions will cause a scar. The incisions will always be closed very carefully.
Data from the cone beam CT scan is used to make the implants. The two most common materials that are used to make skull implants are silicone and Polyether ether ketone (PEEK). Other materials that are used include titanium and medpor.
Generally speaking, skull reshaping surgery is safe. Having said that, and given that it is a surgical procedure, complications can occur. These include infection, bleeding, adverse scarring, alopecia, inadequate correction of the deformity and the necessity for revision surgery.
That depends on what the patient is trying to achieve. An abnormal skull shape can be a source of anxiety and distress to some patients. Once the anomaly is corrected, most patients are happy with their outcomes.