The Brain Surgery Experience

Time Heals, Sort Of

Seven months after the brain surgery. Another view of the dent that's bugging me.

Seven months after the brain surgery. Another view of the dent that's bugging me.

My scar was healing really well. From researching the topic I had read about some silicone products that were supposed to minimize scarring, especially for hypertrophic scars. Since I occasionally get keloid, or raised scars, I was pretty paranoid that I would end up looking like someone who was into tribal body mods with a fat pink scar going from ear to ear on my bald head.

I ordered some tubes of silicone from ScarEase. I also realized that there were similar products available at most drug stores in the form of self-adhesive strips. I bought some strips made by Neosporin called ScarSolution. Over the months I was using them in 2004 I noticed a number of other similar products began appearing on the shelves. I guess the word was out.

In my experience these products work beyond all doubt. I started by testing them on a very visible and raised scar I had from my shoulder surgery while waiting for my head to fully heal and the scabs to disappear. The scars on my shoulder really got flatter and less red.

Once my head was ready I started slapping them across my scalp. On the sides of my head where the scar went into the hairline I would use the gel and cover them with the strips to keep it from rubbing off while I slept. I was wearing a ball cap to work every day so it was easy enough to have the strips on most of the scar all day long. Again, this stuff works. The scar, also helped by the passage of time, became colorless and there is nothing left but a very slight intermittent groove.

That’s the good news. The bad news is that as the scar was healing a very noticeable dent began to appear along the top/side of my head, right next to the scar. As it was explained to me, the reason for this is because of the way they replace the piece of skull they remove for the surgery. In my case this was a sizeable piece of my forehead. Instead of placing the bone back in the center of the hole with an even kerf line (the gap left by cutting it out) all the way around they butt the bone up tight near the brow. This is so there is no gap and everything looks as pretty as possible on the face. The problem is that on the top side the kerf is doubled. Also, since I had the endoscope inserted in the same general location there was another small hole.

Scratch and dent. At least I've had a haircut. This is eight months after brain surgery and about an hour before the fat relocation.

Scratch and dent. At least I've had a haircut. This is eight months after brain surgery and about an hour before the fat relocation.

At first none of this was visible at all. My head was subtly swollen for a pretty long time which I’m sure partially masked it. About four months after my January surgery the weather was getting better and I felt good enough to begin riding my bike again. It was about a month after I began bike commuting to work that I really started to notice the dent. One of the pads pressed right on it and I really thought it was deforming what appeared to be a somewhat malleable part of my skull. I reshaped the padding to avoid pressure on that part of my head.

When I had a follow-up with my main brain surgeon in June I asked about the dent and told him about the helmet. He dismissed the helmet as the problem, but I’m still not sure it didn’t at least exacerbate things. That’s when he explained the kerf and the alignment of the skull piece. I remember in one of my original visits I was told that the skull was sealed with a coral-based cement and held in place with three sets of small strips and screws. I suspect that as the cement dissipated and the growing bone replaced it the bone just didn’t come back as thick as it was. Which I believe is usually the case when a bone break heals. I’m just guessing about the cement. A doctor may read this and laugh. I assume that my skull is pretty thin where the dent is.

As far as the screws go it can accurately and literally be said that I have a screw loose. To hold the replaced skull section in place surgeons typically use three sets of two screws and one strip. Each small strip has a hole for the screw on each end. One end gets screwed into the piece of skull being put back and the other end gets attached to the rest of the skull.

Before I had surgery I remember one of my doctors mentioning the screws and how they are below the surface, etc. “Occasionally I’ll get a patient calling me at night saying ‘I can feel the screws!’ And when I ask them where, it’s not even where we operated.” With that in mind, when I started to feel what seemed like a screw I thought maybe I was just imagining it. And it was pretty far away from where the cyst had been as well. I asked the doctor when I met him in June and he told me “Yes, that is a screw, and I’m not going to tell you where the other five are” with a chuckle. It’s not that obvious, but you can see it and it feels weird if I rub my head.

So, I could live with the scar, but the dent had me bumming. I was still wearing a ball cap at work and most public places. That can often make certain situations awkward. Fortunately I work in a very casual environment. I asked the brain doc if he could recommend someone to do some “reconstructive” surgery. He said he would check into it. Eventually I got the name of a top-notch plastic surgeon. As you might expect this type of practice doesn’t work with insurance, and my insurance company doesn’t work with anyone unless you jump through a lot of hoops. I decided to bite the bullet and just pay for it myself. I didn’t think it would ever be considered a “medical necessity.”

10 Comments on “Time Heals, Sort Of”

  1. 1 Fran said at 8:59 am on August 13th, 2012:

    my surgery was in March of 2012 my head still hurt on scar,but hair is growing fine wanna know when I can expect to regain my old self back I miss Fran.

  2. 2 Tracy Sigler said at 11:44 am on August 13th, 2012:

    Hang in there!

  3. 3 Michael Roque said at 8:53 am on June 9th, 2014:

    I had a cranioplasty to replace infected bone. I still have residual swelling from the procedure but it’s significantly smaller than right after the procedure. How Long does it take for the swelling to completely resolve?

  4. 4 tracysigler said at 6:26 am on June 10th, 2014:

    Hey Michael, That does not sound like fun. I can’t remember for sure but it tapered away slowly, probably several months. It was somewhat subtle, meaning it was an overall swelling not just in one area. Being bald, when I would wear a cap or my bike helmet they would leave noticeable impressions on my head, because it was retaining fluid. I think my doc said that was because my lymph system was disrupted and fluid didn’t move around as it did before. Back to normal now. Hope that helps.

  5. 5 letisa allegra said at 1:29 pm on October 28th, 2015:

    I had a craniotomy to remove a right frontal lobe benign menengioma about six months ago. I could feel the line. The metal bits. On the surface no one else could notice my forehead looked different but I could see a shadow. Then at about 3 and a half months I was on a three hour flight. After that the indentation is really noticeable. I have been searching and this is the first article I have found with any type of explanation. Thank you !! I have an MRI in a few weeks to check on things. Now I wonder if anything can or should be done or if I will just have to live with a different hairstyle and just be glad I am alive and mostly ok.

  6. 6 tracysigler said at 4:04 pm on October 29th, 2015:

    Hey Letisa, Glad you’re “alive and mostly OK.” ;) At least you have the option of different hairstyles. Not sure what to suggest. In hindsight, dealing with a plastic surgeon and getting the fat injections, doesn’t seem worth it. Years later I honestly can’t tell if it made any difference at all. I was told by other surgeons that it takes multiple attempts to get the added fat to stay put, if it ever will. I just got used to being less perfect than before. Good luck! T

  7. 7 Linda Gottshall-Sayed said at 12:17 pm on November 18th, 2016:

    Hey Tracy: I am so glad I found this forum. I had an emergency crainiotomy in 2012 for an active bleed, and a subdural hematoma. I have several severely deep depressions along the area where the skull was cut. I have long white hair to cover my skull. What concerns me is that I have been discovering new, additional skull depressions on the side of my head surgery was performed on … and just yesterday, a new depression on my forehead. This one is slight, but it is on my face. Have you experienced this? Is this an indication of brain atrophy (if you know?)

  8. 8 tracysigler said at 3:48 pm on November 18th, 2016:

    Hey Linda, Sorry you had to go through that. I can’t say I’ve experienced anything like that. It did take several months for the general swelling to completely disappear, but not years. If I were you I would definitely check in with your doctor, even if you have no other symptoms.

  9. 9 Tiffany said at 5:22 pm on December 10th, 2017:

    I had 3 brain surgeries (within a 1 year period) for a giant, benign meningioma and now have multiple screws that portrude and cause a lot of pain!
    Ive now adopted different hairstyles but I’m yet to find one that covers my indented skull. I hate my side profile as its SO obvious from that angle :/
    Also happy to be alive-but wish my circumstances were different :(

  10. 10 tracysigler said at 6:35 pm on December 13th, 2017:

    Thanks for your comment Tiffany. I’m glad you’re alive too, but that definitely sounds like a pain.

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