Custom skull implants provide one of the most effective methods to treat a side variety of head shape abnormalities. Made from a 3D CT scan they provide a preoperative design that hopefully adequately addresses the patient’s aesthetic head shape concerns.
Because of their custom design, most cases do not require any intraoperative adjustment for either fit or aesthetic concerns. But there are the occasional cases where the patient may require a secondary adjustment to address their aesthetic concerns which have become apparent to them after having it in place for a while. (too high, too wide in some areas etc)
Such custom skull implant adjustments are typically made with a large scalpel and done in a shaving manner, removing strips of in a hand carving manner with the implant in placed. While effective, getting a feathered smooth edge that blends well into the surrounding bone or the rest of the contours of the implant can be difficult with a scalpel alone.
To create the fine details of custom skull implant reshaping, a high speed handpiece and burr can be effective. The key is to use a large fluted burr since the gripping surface of a silicone material is slippery and needs the bigger bite of a larger cutting edge. this is very helpful in my experience to get the material surface and its edging as smooth as possible.
Custom skul implants rarely require much or any modification during their primary implantation. But when secondary shape adjustments are desired that involves the need for material removal, the finest details of its shape and edging can be precisely done with the fine touch of his speed equipment.
Dr. Barry Eppley
Indianapolis, Indiana