Cranioplasty is the surgical repair of skull fractures or deformities. These fractures and deformities can happen as the result of a neurosurgical operation that required access to the brain, a traumatic accident or a birth defect. At MedStar Georgetown University Hospital’s Cranioplasty team, we offer surgical treatment for complex problems of the skull. Our multidisciplinary team of neuro-, plastic, craniofacial, and microvascular surgeons work together to achieve the best possible result for you.
Depending on the type and severity of your condition, your treatment strategy will differ. Examples of the conditions we treat include:
- Abnormal head shape: If your head has an irregular or asymmetric appearance that is noticeable, such as the forehead or temples, our team can help restore a normal shape to the head and face.
- Missing bone: If the brain swells due to an accident or condition, part of your skull may need to be removed to allow the brain to expand. Once it is replaced, you may notice a deformity. Our team can replace the bone with bone grafts or a cranial implant and restore soft tissue using microvascular or plastic surgical techniques.
- Temporal hollowing: After a neurosurgical operation, you may notice the muscle in the area of the temple atrophy or disappear. This can cause a hollowed-out look in your temple. Our team can reconstruct the muscle and minimize the deformity.
Planning and Recovery
What to Expect
If you don’t already have a referral, schedule an appointment with one of our cranioplasty specialists. The surgeon will examine your skull and ask questions to determine if you’re a candidate for a cranioplasty procedure. If surgery is recommended, you’ll discuss risks and potential complications of surgery and what will happen during surgery. You will receive directions on what to do prior to your surgery.
During your surgery, you will receive anesthesia to avoid feeling pain. While you are unconscious, the surgical team will prepare your skull with a local anesthetic to further prevent pain. From there, one or more surgical techniques may be used to address your condition. These may include:
- Bone cement, or hydroxyapatite, may be used to smooth irregularities and fill creases of the skull.
- Autologous cranioplasty uses your own bone to restore the normal shape of the head. This bone may be taken from the skull itself, the ribs or the hip.
- An implant may be used when a large amount of skull bone needs to be replaced. These implants are created before surgery using a CT scan of your head.
- Microvascular surgery lets the surgeon bring healthy tissue from a different part of the body, place on a wounded part of the head, and connect the arteries and veins from the transplanted tissue to the existing head tissue.
- Tissue expansion places a device similar to an empty water balloon beneath the skin. This device is expanded using water and enlarges the skin, creating normal healthy skin that can be used to cover exposed bone or damaged tissue.
Recovery from Head Surgery
Most cranioplasty patients spend two to three days in our hospital after surgery. Your care team will examine you to determine if you are ready to go home. It may take around a month or two for swelling and numbness to subside. You will be told a timeline for your specific procedure’s recovery by your surgical care team.
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Frequently Asked Questions
Your cranioplasty procedure may be covered by insurance if it is deemed medically necessary. Please contact your insurance company to determine your coverage.
If you’re exploring options for insurance coverage, you may need to request a referral from your primary care doctor, depending on your health insurance plan. Check with your carrier to see if medical coverage is an option for you and, if so, whether a referral is required.
Cranioplasty, as with all surgeries, carries certain risks:
Before surgery, you may be asked to get blood tests and take or adjust medications. If you smoke, quitting will help you heal faster and avoid possible complications.
You will also need to arrange for transportation to and from the surgery and for someone to stay with you the night after the surgery.