Cranial bone grafting in facial aesthetic and reconstructive contouring

Harvesting of outer-table cranial bone for major craniofacial surgery can be an extensive surgical undertaking. However, when it is used for facial cosmetic and reconstructive contouring, it can be a relatively minor procedure. Our experience with harvesting outer-table calvarial bone and its placement in the face will support a more liberal use of this material. Over a period of 24 months, we have performed outer-table calvarial bone grafts on 62 patients, totaling 367 individual grafts, which were placed in an average of three separate facial sites per patient. The grafts have been easily taken in a prompt fashion with little postoperative discomfort or graft-site deformity. We have not experienced significant complications in harvesting or in placement of cranial bone. The contour provided in the face is quite natural and predictable.