Every plastic surgery procedure has numerous issues that every patient who is undergoing a procedure should know. These explanations are always on a consent form that you should read in detail before surgery. This consent form, while many perceive as strictly a legal protection for the doctor, is actually more intended to improve the understanding of the various skull reshaping procedures. The following is what Dr. Eppley discusses with his patients for these procedures. This list includes many, but not all,of the different outcomes from surgery. It should generate both a better understanding of the procedure and should answer any remaining questions that one would have.
ALTERNATIVES
There are no alternatives to surgical skull reshaping. Some small skull defects may be treatable by a fat injections or bone cements placed through a minimal incision injection approach. High spots or skull reduction can not be reduced by a non-incisional approach.
GOALS
The goal of skull reshaping surgery is to create a more normal appearing skull contour. In some cases, this may require building up the bone, reducing raised areas or a combination of both reshaping techniques to get the optimal skull contour.
LIMITATIONS
The limitations of any cranioplasty procedure are how much of an incision can the patient tolerate (access and exposure), how much the skull can be built up based on the scalp’s ability to stretch and the thickness of the skull bone when reductions are being done.
EXPECTED OUTCOME
Expected outcomes include the following: temporary swelling of the scalp even extending down into the face, scalp skin numbness, a permanent scalp scar, the implantations of various biomaterials for augmentation/buildup including microcrew anchorage and months of healing and tissue settling until the final result is seen in all aspects. Healing of any cranioplasty procedure is a process and the minimal amount of time to judge the result is three months and may take as long as six months to see the very final result in many cases.
RISKS
Significant complications from skull reshaping surgery are very rare but could include infection. More likely but uncommon occurrences could include a wide scalp scar, potential hair loss along the incision, suture reactions along the incision edges causing local wound healing problems, edge demarcation/irregularities along any implant-bone interface, overcorrection of the skull contour, undercorrection of a skull contour, and asymmetries and irregularities of the skull contour. Any of these risks may require revisional surgery for improvement.
ADDITIONAL SURGERY
Should additional surgery be required to revise a scalp scar, adjust a bone or implant contour or perform aesthetic adjustments of the initial skull reshaping will generate additional costs.