Cranioplasty

There are several reasons why a neurosurgeon might recommend a cranioplasty:

To protect your brain

If there is a defect on the skull, this may leave the brain vulnerable to injury. A cranioplasty can repair the damage in your skull to offer additional protection to your brain.

To improve your neurological function

Trephine syndrome, also known as 'sinking skin flap syndrome', may develop after a craniectomy, which sometimes causes neurological deterioration. By restoring the skull flap through a cranioplasty, neurological function could be improved.

Aesthetic reasons

Although rare, some people may choose to have a cranioplasty in or make a skull defect less noticeable.

Most people will start their treatment journey at Circle Health Group with an initial consultation. This is a very important appointment, where you and your consultant brain surgeon will get to know each other, and they will begin a diagnosis of your brain problems.

Even if you have already had a diagnosis from elsewhere, for example if another doctor has recommended that you need a cranioplasty operation, your Circle consultant will still want to make their own diagnosis, just to be as safe and thorough as possible.

They might start by asking you to talk them through your symptoms as well as your medical history, and they will probably perform a physical examination, too.

If any tests are needed to confirm a diagnosis, our hospitals have extensive imaging departments and experienced teams of radiologists, so you'll get fast access to any diagnostics that you need, and you won't have to wait long to get the results back.

One your consultant neurosurgeon has made their diagnosis, they will talk you through the available treatment options and together you'll make a decision about what's right for you.

If cranioplasty is the right choice for you, we'll put together a quote for a fixed-price treatment package and confirm this in writing. As soon as you're happy with the plan, we can go ahead and get you booked in for surgery on a date that suits you.

If a cranioplasty is the best treatment option for you, your consultant neurosurgeon will arrange a pre-operative appointment. This is to prepare you for the surgery, explain the risks and benefits of the operation, and explain what to expect once you have been admitted to one of our Circle Health Group hospitals.

Your consultant neurosurgeon may also request that some tests are carried out ahead of your surgery. This may include:

• A physical examination
• Blood tests
• A neurological exam
• An imaging scan of the brain (MRI scan or CT scan)

There are various different types of cranioplasty and the one you have will depend on the reasons you are having the surgery.

In general terms, a cranioplasty involves lifting the scalp and restoring the shape of the skull. This is done using either a piece of your original skull (called an autologous graft or autologous cranioplasty), using a bone from another part of your body (a graft), or using an implant. Implants are commonly made from either titanium, a synthetic material that acts as bone substitute (this is sometimes referred to as a 3D printed cranioplasty), or a solid biomaterial.

What to expect during surgery

Cranioplasty is performed under general anaesthetic, which means you'll be asleep during the operation and you won't remember it afterwards.

Once you are asleep, you will be given a local anaesthetic at the site where your surgeon will make their incision. They will then carefully cut the skin of your scalp and separate it into layers. The area where your skull is to be repaired will be cleaned and prepared so that the bone graft or implant can be positioned properly. Once they are happy with its position, it will be secured to your skull with screws, plates or both.

Your surgical team will then carefully close the incision in your scalp, making sure everything is in the right place before sealing the wound with stitches.

Recovering in hospital

Once your surgery is complete, you will be taken to the recovery area of the theatre, where nursing staff will monitor your heart rate, breathing and other vitals. Once you have been assessed and deemed ready to be moved out of theatres, you will be taken either to the intensive care unit (ICU) or directly to the ward.

Some people will have a small suction drain attached to their head after surgery to remove any excess fluid, but this should be removed after a few days.

Your Circle Health Group nursing staff will monitor your recovery and ensure you are well looked after. You may find that you are more fatigued than normal and end up having a lot of naps, which is natural as your body heals. You are also likely to experience some headaches following your cranioplasty.

Once your neurosurgeon deems it safe to do so, you will be discharged, where you can continue to make your recovery. Typically, this is after 1-2 days after your operation.

Continuing your recovery at home

Cranioplasty is a major surgery and it will take you a while to feel completely back to normal after you get home from hospital.

At first, you'll be very tired. Many people find they need to lie down or sleep in the afternoon. You might still have headaches for a while, and just generally feel 'not yourself'.

We will make sure you have follow-up appointments with our team to keep track of your recovery and to remove any stitches you might still have.

There are certain symptoms that can be the sign of a problem after surgery, including worsening headaches, fever, seizures, or any problem with the wound such as swelling or signs of infection, or fluid leaking from it. Contact your care team immediately if you do notice any of them. They should have let you know all about what to look out for before you left the hospital.

You won't be able to drive for at least two weeks after surgery, and your surgeon will need to assess you to decide when you are ready to get back behind the wheel. You should also speak to your insurance company as they may have separate rules about when you're covered again.

How long does it take to recover from a cranioplasty?

For a period of six to 12 weeks after your surgery, you should expect to have your activities limited. This may include not carrying weight, not driving and not exercising.

In terms of a full recovery, your neurosurgeon will advise you as to your personalised recovery plan, which will depend on the complexity of the brain surgery you have had.

Any brain operation, as with any surgery, comes with potential risks and complications. Your surgeon will discuss these with you beforehand so that you can make an informed decision.

Potential risks of a cranioplasty include:

• Infection
• Blood clots
• Stroke
• Seizures
• Heart attacks

When you go private with Circle, you can expect:

• Fast access to appointments with brain specialists, often within 48 hours of getting in touch
• Your choice of consultant, at a hospital location that suits you
• Flexible appointment times to fit your schedule
• Consultant-led treatment from start to finish
• Bespoke treatment plans built around your individual needs
• Private ensuite rooms as standard with TV and wifi included
• Flexible payment options to help you spread the cost

If you have been told you need a cranioplasty or would like to get the advice of a brain specialist, call us or book online today and we’ll help you find the best treatment for you, fast.

Content reviewed by Circle in-house team in September 2022. Next review due September 2025.