MedStar Georgetown's Cranioplasty Team
The MedStar Georgetown cranioplasty is a multidisciplinary focused team of excellence that specializes in the treatment of complex problems associated with the skull or overlying skin and muscle. Our team is comprised of neuro, plastic, craniofacial, and microvascular surgeons who work together to achieve the best possible result for you.
Our patients often present with the following abnormalities: nonhealing wounds, abnormal head shape, or missing bone. These abnormalities occur as a result of previous surgery, skin cancer, or radiation.
The multiple specialists within our team work together to return the patient to their preoperative appearance and minimize the stigma of previous surgery.
Conditions We Treat
Neurosurgical operations require obtaining access to the brain through the safest approach that minimizes complications; however, it is not unusual for a neurosurgical procedure to leave a visible deformity of the skull. MedStar Georgetown's Cranioplasty team specializes in evaluating and treating and any concerns a patient may have related to the appearance or function of their head. While it is normal to not be concerned about your appearance immediately after brain surgery, it is not uncommon for patients to inquire about any postoperative irregularities once they have safely recovered from surgery. The MedStar Georgetown's Cranioplasty team offers every neurosurgical patient an evaluation six months after their operation to address any concerns they might have about their appearance. Common concerns are related to scars, temporal hollowing, or contour irregularity. Some of the common conditions our team evaluates are described in more detail in the following section.
Abnormal Head Shape
An abnormal head shape may occur for several reasons. Previous surgery may have resulted in the loss of bone or the resorption of bone leaving an irregular or asymmetric appearance. This is less of a concern when the area is located under the hair. However, in visible areas such as the forehead or temples, the irregular shape can be of greater attention. Our team is experienced in restoring a normal shape to the head and face giving you an appearance that is close to normal.
Some patients may be missing bone from their skull. This occurs in traumatic accidents when the brain swells and the bone needs to be removed to allow the brain to expand. After the bone is removed, it is frozen or placed in the patient's abdomen to preserve it while the brain swelling goes down. Frequently, when the bone is replaced, it dissolves resulting in significant deformity of the skull. This may result in loss of cognitive functions as well as significant deformation of the skull due to the resorption of bone. Our cranioplasty team will replace the missing bone with either bone grafts or a cranial implant and restore the soft tissue using microvascular or plastic surgical techniques.
Occasionally after neurosurgical operations, the temporalis muscle may atrophy or disappear. This is the muscle that is in the area of the temple. This presents as a hollowed out appearance in the patient's temporal region after their surgery/operation/procedure. Our team has specialized techniques to reconstruct the temporal hollowing and minimize this deformity allowing the patient to have a normal appearance.
Occasionally, a surgical scar heals in an unfavorable manner. This may present as a hypertrophic scar or a keloid scar that can be improved. Although it is impossible to eliminate scars completely, it is usually possible to improve the appearance of a scar with plastic surgery. Our team is exceptional in their techniques of reducing scars and improving patient satisfaction.
Previous radiation treatments often produce chronic wounds that are difficult to manage. The radiation has adverse effects on tissue making wounds much harder to heal. The microvascular experts within our cranioplasty team have extensive experience in using healthy tissue to repair head wounds damaged by previous radiation. Using a technique called microsurgery, surgery that is performed using miniature instruments and a microscope, the surgeon will collect a piece of tissue from a part of the body, non-damaged by radiation and place it in the damaged area for healing.
Skin cancer may result in a loss of soft tissue and in severe cases, even erode into the skull bone. In these cases, our cranioplasty team will successfully remove the skin cancer as well as any affected bone. Once the skin cancer has been removed, we will use reconstructive techniques to restore both the skeletal and soft tissue portion of the skull. In addition, we work directly with our dermatology team to schedule routine follow-ups allowing for management of skin health after your procedure.
Learn more: Overview of Techniques