Cranioplasty with a silicone prosthesis and split rib grafts.

A method to reconstruct visible cranioplasty defects involving the anterior cranium with the durability of bone and the exacting contours of the custom silicone implant is described. This technique is simple, quick, and does not require intraoperative assessment of subtle contours. The patient has a rigid underlying bony support with a perfectly contoured external surface. In patients with cranioplasty involving the cranium anterior to the hairline, we take advantage of both split rib grafts and a silicone prosthesis in one stage to obtain optimal results.