Heavy metal: beware

A 19-year-old Crouzon's syndrome patient with a history of multiple craniofacial procedures presented with severe bilateral temporal and frontal depressions and metal implants protruding through the scalp in multiple locations. Preoperative analysis revealed an extensive cranial defect that had been reconstructed with multiple large metallic mesh implants. The mesh required complete removal with an autograft cranial reconstruction. We present this case to urge that caution and forethought be exercised when contemplating the use of metallic alloplasts for major craniofacial reconstructions.