Skull Reshaping – Revision Surgery

Are You the Right Candidate for Skull Reshaping?

IMPORTANT: To make the best use of your time and ours, please read the following points BEFORE you call our office:

• It is not uncommon for the cost of skull reshaping surgery to cost within the range of approximately $20-$25k, although costs may vary dramatically based upon what is required.
• Your surgery may involve a custom implant, and/or necessitate the need for a neurosurgeon to be involved; both of which will be at an often substantially significant additional cost.
• Manufacture of custom implants will often cost $5-8k, depending on the size of the implant.
• It is absolutely necessary to have a CAT scan (an out-of-pocket expense with most insurance companies for aesthetic surgery) prior to or as part of your evaluation. This is not optional and is also a significant expense.
• You may have visible scars on your head depending on the scope of surgery and/or style of your haircut. If you wear your hair either shaved or very short the scars will likely be visible.
• We DO NOT undertake skull reshaping surgery based on how your hat fits.
• NOTE: Although it is possible to make your head larger or smaller, this is not safe for cosmetic surgery. This is only undertaken jointly with a neurosurgeon for those who have cephalocranial disproportion

If, after reading all of the above, you wish to move forward, you need to be available for an in-person consultation at our San Francisco clinic with Dr. Deschamps-Braly. We do not accept telephone or Skype consultations.

Skull Reshaping – Revision Surgery

Skull reshaping surgery, otherwise known as skull contouring or back-of-head augmentation is an aesthetic craniofacial surgical procedure. Typically this procedure is used to change the shape of the skull to give it a more aesthetically pleasing appearance. The skull reshaping procedure can be performed on males or females, adults, children or teens, essentially anyone who is unhappy with the shape of their skull due to congenital abnormalities or previous surgeries in the case of accidents or illness.

Why Is It Sometimes Necessary to “Revise” a Previous Skull Reshaping Surgery?

If skull reshaping is performed by an inexperienced or unqualified surgeon the patient may experience an unsatisfactory result. Negative results may also occur due to infection or the body’s rejection of a skull reshaping implant.  In fact, revision or correction of skull reshaping surgery is actually quite common — about 15% of all or our skull reshaping procedures are revision surgeries wherein we are asked to correct a previous surgeon’s work. Typically the smaller the procedure, the less need for surgical revision. The larger the skull reshaping procedure, the greater the chance for an unsatisfactory result and the need for revision.

Specific Problems That Necessitate the Need for a “Do Over” Skull Reshaping.

Previous aesthetic skull reshaping, or cranioplasty surgeries for congenital deformities, may result in an asymmetrical or irregularly shaped skull. At the time of the original surgery the skull shape may have appeared to be fine, but after a few weeks or months of healing lumps or hollows may reveal themselves. Typically skull reshaping surgery is quite safe, with rates of infection or rejection of implants, being quite rare. However, sometimes infection, fluid build up, or irregular bleeding may occur, resulting in a poor outcome to the eventual shape of the skull.

Sometimes low-quality bone cement may have been used to fill in hollows or depressions in the skull bone. These types of cement sometimes lose shape over time causing lumps, bumps, and “dents” to occur. We use only best-practice synthetic biomaterial such as polymethyl methacrylate (PMMA) hydroxyapatite (HA), or (PEEK) Polyetheretherketone, highly recommended fill-in materials for use in craniofacial surgery.  

Another problem that may occur with reductive skull reshaping procedures — wherein skull size is reduced or smoothed out using a rotary or burring tool is that an inexperienced surgeon may, in fact, remove too much of the skull, resulting in an unsatisfactory shape. To fix this problem we would use polymethyl methacrylate (PMMA) or hydroxyapatite (HA) as a filler.

The Aesthetic Talent and Detailed Artistry of the Perfect Skull Shape.

Possibly the most common reason that our patients have to request a skull reshaping revision surgery is that they are simply not satisfied with the overall shape of their “new” skull. This is because the previous surgeon possibly did not take into account the patient’s overall head shape as it complements their other facial features such as their nose shape, chin, jawline, cheekbones, or forehead. And herein lies the secret to success in skull reshaping: The shape of the skull must “sit” in harmony with all other facial features. Too often an inexperienced surgeon is lacking in an “artistic eye” for what constitutes aesthetic harmony. They will look at the shape of the skull in isolation, rather than as an integral part of the overall interplay of facial features.  

How Is a Revision Skull Shaping Procedure Performed?

Like all craniofacial surgery, skull reshaping is performed under general anesthesia. You will not need to shave your hair and minimal hair will be trimmed during the procedure. The procedure is typically quite similar to standard skull reshaping surgery but may take more planning, or a little longer in the operating room than your initial surgery. If reshaping is needed to flatten out bumps, ridges, or high spots, the bone will be smoothed out using a rotary or burring tool. If the skull needs to be “filled” or rounded out, a synthetic biomaterial such as polymethyl methacrylate (PMMA) and hydroxyapatite (HA) is used. A custom-made skull implant may also be used depending on your desired head shape. These materials are all biologically safe and will bond with your own bone, with very low chance of rejection.

Why Should Your Skull Shaping Revision Surgeon Be Us Board Certified?

To ensure your long-term peace of mind, when choosing a surgeon for your skull reshaping revision surgery, make sure that your surgeon is fully-qualified, US Board Certified, and possesses long-term craniofacial and plastic surgery experience. It is critical that your surgeon has an intimate and in-depth understanding of not only plastic surgery but the entire craniofacial skeleton.

Need More Information About Skull Reshaping Surgery?

• Skull reshaping and augmentation – main page: read all about skull reshaping and augmentation
• Skull reshaping in children and teens: is often due to congenital skull shape abnormalities.
• Skull reshaping recovery timeline and tips: Even though skull reshaping (back-of-head augmentation) seems like it would be a major operation, recovery time can actually be quite rapid compared to other aesthetic craniofacial procedures.