Cranioplasty Surgery: Skull Repair with Your Own Bone, Titanium or PEEK

What Is Cranioplasty Surgery?

Cranioplasty surgery closes a gap in the skull with your own stored bone or a custom implant. Most often, it follows a craniectomy, an operation that removes part of the skull to give a swollen brain room.

So the goal goes beyond looks. In fact, a closed skull protects the brain again and restores the pressure balance inside the head.

In most cases, cranioplasty is a planned operation, not an emergency. Therefore you, your family and your surgeon can choose the timing and the material together.

At a Glance

• Who it helpsPeople with a skull gap after craniectomy, infection, a tumor or a skull fracture
• Usual timingOften six to twelve weeks after craniectomy; later after an infection
• MaterialsYour own bone, titanium, PEEK or bone cement (PMMA)
• OperationGeneral anesthesia, often one to two hours, through the old scar
• Hospital stayUsually three to five days
• Main riskInfection of the bone or implant

Where Are You in Your Decision?

Pick the line that sounds most like you. Each one then opens the matching part of this guide.

1. 01Do I really need the bone put back?What an open skull does to the brain→
2. 02When is the right time for surgery?Early or late cranioplasty, side by side→
3. 03Own bone, titanium or PEEK?All four materials compared→
4. 04What happens during the operation?Five steps, from the scar to the last stitch→
5. 05I want to know about risks and recoveryWarning signs, rules and the timeline→
6. 06I am planning surgery from abroadLength of stay, flights and follow-up at home→

Why Cranioplasty Is Necessary After Craniectomy

A skull gap leaves the brain under skin alone. Over time, this causes four problems, and each one is a reason to close the gap.

Questions at this stage

When to Call Your Doctor Before or After Cranioplasty

First, report changes in the skull gap while you wait for surgery. After the operation, however, signs of infection or pressure need an emergency department at once.

Why Speed Matters

For one thing, an infection can spread to the implant or the brain lining. Then early antibiotics may save the implant, while delay often means its removal. So never wait for a planned visit once fever or wound discharge appears.

When Is Cranioplasty Done?

Prof. Albayrak often plans cranioplasty six to twelve weeks after the craniectomy. Still, three conditions come first: the swelling has gone, the scalp has healed and there is no active infection.

Doctors usually call surgery within the first three months early cranioplasty. After that, it counts as late cranioplasty.

Today, the trend favors early repair when conditions allow. After an infection, however, Prof. Albayrak waits at least three to six months. So each timeline is personal.

Cranioplasty Materials: Own Bone, Titanium, PEEK or Bone Cement

There are four main ways to close the gap. The choice depends on the size of the gap, any past infection, your age and the state of your stored bone.

Where Your Own Bone Waits

During a craniectomy, the surgeon keeps the removed bone in one of two ways. For example, it can go under the fat of the belly wall, where it stays alive. Otherwise, a bone bank stores it in a deep freezer.

The belly method needs a second small cut to take the bone out again. Freezer storage avoids that cut, but the bone tends to dissolve more after it goes back. Either way, the surgeon checks the bone first, and a weak or broken flap means an implant instead.

How a Custom Implant Takes Shape

First, a thin-slice CT scan of your skull becomes a 3D model. Next, the software mirrors the healthy side to design the missing piece. A maker then produces the titanium or PEEK implant to the millimeter.

As a result, the implant fits without shaping in surgery. Symmetry also tends to look better, and the operation is often shorter.

How Cranioplasty Surgery Works

Cranioplasty takes place under general anesthesia and often lasts one to two hours. In most cases, the surgeon opens the old scar, so there is no new cut on the head.

1. Lifting the scalp: the surgeon gently frees the skin and muscle from the brain lining. After a long wait, this step takes the most time.
2. Protecting the lining: the lining is thin and often sticks to the scalp, so the work happens under a microscope or magnifying lenses. Any small tear gets a repair at once.
3. Fitting the bone or implant: the piece goes into the gap and small titanium plates hold its edges.
4. Placing a drain: a thin tube under the skin stops blood from collecting. It usually comes out within one to two days.
5. Closing: the surgeon stitches muscle and skin in layers, then covers the wound with a dressing.

If your own bone sits in the belly wall, the surgeon first takes it out from there. This adds about half an hour. A custom implant, by contrast, skips that step.

When a tumor has grown into the bone, the plan covers both problems together. Our guides to meningioma and brain tumors explain those operations.

Cranioplasty Risks and Long-Term Effects

Cranioplasty is not among the hardest brain operations. Still, problems happen more often than many people expect, because most patients have lived through a serious brain illness.

• Infection: the most common and most important problem. An infected bone or implant often comes out, and a new one goes in months later.
• Blood or fluid under the skin: the drain helps; sometimes it still needs draining.
• Bone dissolving: your own bone can slowly shrink, more often in children and in broken flaps.
• Hydrocephalus: some people then need a shunt, as our guide to hydrocephalus treatment explains.
• Seizures: more likely after brain injury, so many patients get preventive medicine for a while.
• Bleeding on the brain surface: rare, but possible while the lining separates.
• A visible or palpable edge: under thin skin, you may feel the rim of a titanium plate.

How Planning Lowers the Risk

Good timing, the right material and careful technique all reduce these risks. For example, after an infection, a longer wait and a titanium or PEEK implant lower the chance of a new infection. So planning matters as much as the operation itself.

Cranioplasty Recovery Time

After cranioplasty, most people spend one night under close watch and go home in three to five days. Then the next six weeks call for gentle activity.

What Happens After Cranioplasty

Many people in rehabilitation make faster progress once the skull closes. For this reason, the therapy team often reviews the program after surgery.

Also, keep taking any seizure medicine until your doctor stops it. If you smoke, stop well before surgery, because smoking slows wound healing.

Cranioplasty in Children

A child's skull keeps growing, so the material choice changes. Surgeons prefer the child's own bone, since living bone grows with the head. However, bone dissolving happens more often in children, so follow-up scans come more often.

In some young children, the surgeon splits a piece of skull bone into two layers to cover the gap. For skull shape problems from birth, see our guide to craniosynostosis.

Coming to Istanbul from the US, Canada, the UK or Europe

Cranioplasty is a planned operation, so it suits a trip you arrange ahead. Before that, however, the swelling and any infection must have settled at home.

How Long to Stay in Istanbul

First, count the consultation, a fresh CT scan and three to five days in hospital. Then add the time until your surgeon clears you to fly. With your own stored bone or a hand-shaped implant, many people stay about two weeks in total.

A custom PEEK or titanium implant, however, needs production time after the CT scan. So the trip may become two visits, or one longer stay; your surgeon explains the options at the consultation.

When You Can Fly Home

The UK CAA advises waiting about seven days after surgery inside the skull, since trapped air can expand at altitude. So your surgeon sets the date at the check-up, often after a control CT.

Also, the US CDC warns that flying soon after surgery raises the risk of blood clots.

Follow-Up at Home

Before you leave, ask for the operation report, the implant details and your scans. Then share them with your local neurosurgeon and rehabilitation team.

For insurance and Medicare, see planning surgery in Turkey from the US. For NHS rules and travel insurance, see planning from the UK. From Canada, check with your provincial health plan and private insurer before you book.

Your Cranioplasty Surgeon in Istanbul

Prof. Dr. Serdar Baki Albayrak

Neurosurgeon · Full Professor of Neurosurgery

Prof. Albayrak repairs skull gaps after craniectomy, infection, tumors and fractures. He first weighs timing and material with you, then closes the gap with your own bone or an implant.

After medical school at Marmara University, he trained in neurosurgery at Istanbul University. Clinical fellowships at the University of Helsinki and Harvard Medical School followed.

27+Years

5,000+Operations

64Countries

33Publications

Figures from Prof. Albayrak's professional profile, September 2026. See his full publication list.

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