Surface irregularities and depressions may be secondary to treated or untreated frontal bone fractures.
The most common camouflaging techniques are the following:
Small full thickness craniotomy defects, usually as a result of trephination (eg. burr holes) can also be repaired using titanium mesh.
Frontal sinus drainage evaluation is critical in the treatment planning, and should be assessed with detailed imaging and/or endoscopy. Direct communication with the frontal sinus results in an increased risk of infection.
Note: The use of bone cement is contraindicated in cases with frontal sinus communication.
The surgical indication is usually cosmetic and therefore minimally invasive approaches should be considered.
Although, existing scars afford direct access, remote incisions avoid the potential wound dehiscence and material exposure.
An acceptable soft tissue thickness over the defect is needed for a successful result.
Centrifuged fat is injected radially.
7. Aftercare following camouflage
Head of bed elevation may significantly reduce edema and pain. A cooling mask may be used to further reduce edema. A compressive head dressing is left in place until suction drains are removed (24-48 hours postoperatively). Thereafter routine wound care should be instituted.
Analgesia as indicated
The use of antibiotics in the perioperative period is recommended
Regular patient follow-up after discharge including periodic imaging is recommended.