Concierge neurosurgery · UK
Cranioplasty — rebuilding the skull after craniectomy.
A patient guide to cranioplasty — the timing, the material choice (autologous bone, titanium, PEEK, hydroxyapatite), what the recovery actually looks like, and how the syndrome of the trephined tends to lift once the vault is closed.
Why patients choose us
- 01
A consultant neurosurgeon, in theatre
Not a general team and not a training list. A named neurosurgeon with a cranial-reconstruction caseload, working in a proper cranial theatre with neuro-anaesthesia support.
- 02
A 3D CAD-CAM design lab, on the case
Custom implants are planned from your CT — a design lab producing a titanium, PEEK or hydroxyapatite plate that fits your defect to the millimetre, before the day of surgery.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private cranioplasty costs in the UK.
Indicative ranges across our partner units. Send the details and we quote firm figures across two or three options.
In short
A custom PEEK cranioplasty in our network: £22,000–£38,000, home in a few days.
| Option | Indicative range | Typical duration | Inpatient stay |
|---|---|---|---|
| Cranioplasty with autologous bone flap | £12,000–£22,000 | 2–3 hr GA | 2–5 nights |
| Cranioplasty with titanium mesh | £15,000–£26,000 | 2–3 hr GA | 2–5 nights |
| Cranioplasty with PMMA (bone cement) | £14,000–£24,000 | 2–3 hr GA | 2–5 nights |
| Custom 3D-printed PEEK implant | £22,000–£38,000 | 2–3 hr GA | 2–5 nights |
| Custom 3D-printed titanium implant | £24,000–£42,000 | 2–3 hr GA | 2–5 nights |
| Custom hydroxyapatite implant | £26,000–£45,000 | 2–3 hr GA | 2–5 nights |
| Neurosurgical consultation | £300–£500 | 45–60 min | Same visit |
Prices vary by unit, by the neurosurgeon, by the implant material and design lab, and by the size and complexity of the defect. Combined plastics input for a soft-tissue flap adds to the cost. We come back with a firm quote within one working day.
The problem
The right timing, the right material, the right surgeon.
Cranioplasty looks straightforward on paper and is anything but. Timing, implant choice and surgeon experience each pull the infection rate and the cosmetic result in different directions. We line all three up before you commit.
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Bone flap or custom implant?
The default is often the stored autologous flap. It is not always the right choice — resorption and infection rates matter. We put the trade-off in front of you.
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Feeling worse since the craniectomy?
The syndrome of the trephined is real and often reversible. Cranioplasty can lift cognition, mood and function within weeks.
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Want it planned properly?
A named consultant neurosurgeon, a CAD-CAM design lab where custom is chosen, and a neurosurgical unit with HDU cover on site.
The journey
From planning to recovery — what happens, in order.
Planning takes weeks, surgery takes hours, and the cognitive lift keeps arriving for months.
Phase 1 · Planning
Imaging, material choice, CAD-CAM
Phase 2 · Surgery
A day case with ward stay
Phase 3 · Recovery
Wound, cognition, follow-up
- 01
Planning
You tell us what happened
A short, confidential form. When the craniectomy was, why (trauma, stroke, tumour, infection), and where the bone flap is now — freezer, subcutaneous pocket, or discarded.
- 02
Planning
Imaging and planning
A fine-cut CT of the skull is used to plan the reconstruction. If a custom implant is chosen, a CAD-CAM design is produced and signed off before manufacture.
- 03
Planning
Timing the surgery
Cranioplasty is usually done three to six months after the craniectomy — once the swelling has settled and the wound is stable. Sooner if the syndrome of the trephined is disabling.
- 04
Surgery
Admission and anaesthetic
A morning admission to a neurosurgical unit. Consent, marking, and general anaesthetic delivered by a neuro-anaesthetist.
- 05
Surgery
The reconstruction itself
The old scar is re-opened, the defect exposed, and the implant — autologous bone, PEEK, titanium mesh, PMMA or hydroxyapatite — fixed in place with plates and screws. Two to three hours typically.
- 06
Recovery
Ward recovery
Two to five nights on a neurosurgical ward, with a drain for 24 to 48 hours. Imaging before discharge to check position and rule out early complications.
- 07
Recovery
Recovery and review
Wound review at two weeks, neurosurgical review at six. Cognitive and functional improvement — the reversal of the syndrome of the trephined — often continues over three to six months.
Typical timeline: 3–6 months after craniectomy to surgery. Full cognitive recovery: 3–6 months after.
When it helps
When cranioplasty is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Post-trauma craniectomy
A skull defect left after decompressive craniectomy for traumatic brain injury — the commonest reason for cranioplasty in the UK.
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Post-stroke craniectomy
Reconstruction after decompression for malignant middle cerebral artery infarct or large intracerebral haemorrhage.
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Post-tumour craniectomy
Rebuilding the vault after resection of a meningioma, skull metastasis or primary bone tumour that took the overlying bone.
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Post-infection defect
A defect left after removal of an infected bone flap — usually reconstructed with a custom implant rather than the original bone.
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Syndrome of the trephined
Headache, cognitive slowing, weakness or mood change that only appeared after the craniectomy — often reversed by cranioplasty.
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Cosmetic contour restoration
A visible or palpable depression in the skull that is affecting confidence, sleep on that side, or headwear.
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Bone flap resorption
An autologous bone flap that has partially reabsorbed and lost structural integrity — a common reason for revision to a custom implant.
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Red flag: exposed implant or CSF leak
Skin breakdown over the implant, clear fluid leaking from the wound, or spreading redness is an emergency — same-day A&E, not a clinic booking.
Implant options
Autologous bone, or a custom implant — the honest comparison.
What each material actually involves — and which one fits which defect.
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Autologous bone flap
Your own bone, stored in a freezer or a subcutaneous abdominal pocket after the craniectomy. Biological match, no implant cost — but a higher rate of infection and resorption.
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Titanium mesh
A thin, malleable mesh shaped on the table. Strong, well tolerated, low infection rate — but a visible contour under thin skin can be a drawback.
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PMMA (bone cement)
Polymethyl methacrylate moulded intra-operatively or pre-formed. Cost-effective and strong, but generates heat as it sets and offers no bone integration.
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PEEK (custom 3D-printed)
Polyether ether ketone — a rigid polymer machined from your CT to fit the defect exactly. Radiolucent, lightweight, and cosmetically excellent.
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Custom titanium implant
A 3D-printed titanium plate matched to your skull. The strongest option, well suited to large or complex defects — but visible on imaging.
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Hydroxyapatite (custom)
A bioceramic implant that partially integrates with native bone over time. Lower late-infection rate in the evidence, higher upfront cost.
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Combination reconstruction
Custom implant combined with a vascularised soft-tissue flap where the overlying skin is thin, scarred or previously irradiated.
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Consultation and planning only
An honest discussion of timing, material choice and expected recovery — no obligation to proceed.
Our vetted UK network
A small panel of neurosurgeons, we picked them.
Consultant neurosurgeons across London and the major UK centres, working with the CAD-CAM design labs that produce the custom implants. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every neurosurgeon in our network.
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Consultant neurosurgeons with a subspecialty cranial-reconstruction caseload
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Access to CAD-CAM design labs producing PEEK, titanium and hydroxyapatite implants
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Neuro-anaesthesia and neuro-HDU support on site
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Combined plastics input where the overlying scalp is thin, scarred or irradiated
Safety and recovery
What to expect afterwards — honestly.
Cranioplasty is a well-defined operation with real risks and, for most patients, a real functional payoff. The things worth planning are infection prevention, the follow-up plan, and knowing what is normal and what is not.
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Infection is the main risk
Around one in ten cranioplasties develops an infection, higher for autologous bone than for custom implants. An infected implant usually has to come out and be replaced later.
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Bone flap resorption is common
Autologous bone flaps — especially in younger patients — can partially reabsorb over months to years. Revision to a custom implant is sometimes needed.
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Seroma and epidural haematoma
Fluid collections and small bleeds under the implant are not rare in the first few days. A drain and close monitoring usually manage them without a return to theatre.
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Seizures
Cranioplasty can occasionally provoke a seizure in the first weeks. Anticonvulsant cover is discussed for patients with prior seizure history.
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Hydrocephalus unmasked
Restoring the vault can unmask hydrocephalus that the open defect was compensating for. It is looked for actively and treated with a shunt if it develops.
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Wound dehiscence and CSF leak
The scalp needs to close cleanly. Poor healing, dehiscence or CSF leak through the wound needs prompt re-operation to protect the brain.
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Cosmetic result — usually good
Custom implants give a near-perfect contour. Autologous bone can look slightly irregular, and titanium mesh can be visible under thin skin.
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Syndrome of the trephined resolution
Cognitive and functional improvement after cranioplasty is real and often striking — reported in a majority of patients with pre-operative symptoms.
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Red flags after surgery
Fever, spreading redness, clear fluid leaking from the wound, a new seizure or new weakness are not normal — call the unit or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever material was used, the note the neurosurgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and defect described
Why the cranioplasty was done, where the original craniectomy was, and the size and shape of the defect being reconstructed.
- 02 Technique
Material, planning and fixation
Which material was used — autologous, PEEK, titanium, PMMA or hydroxyapatite — whether it was custom CAD-CAM planned, and how it was fixed in place.
- 03 Findings
Dural condition, brain and complications
The state of the dura, any brain findings on exposure, blood loss, drain placement, and any intra-operative complications encountered.
- 04 Impression
Recovery, follow-up and warning signs
Read this first: expected recovery timeline, follow-up plan, anticonvulsant advice, and the specific warning signs to act on.
Recognised by major UK insurers
Cranioplasty is usually covered by insurance where it is medically indicated. Custom implants sometimes need pre-authorisation. We confirm cover before booking.
Frequently asked
Everything we get asked about cranioplasty.
Quick answers on timing, material choice, complications, recovery and the syndrome of the trephined.
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What is a cranioplasty?
Cranioplasty is the surgical reconstruction of a defect in the skull — usually one left after a decompressive craniectomy for trauma, stroke, tumour or infection. The gap is closed with the original bone flap, a moulded material such as PMMA or titanium mesh, or a custom 3D-printed implant made from PEEK, titanium or hydroxyapatite.
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When is the right time to have a cranioplasty after a craniectomy?
Typically three to six months after the craniectomy, once the brain swelling has settled and the scalp is stable. It can be sooner if the syndrome of the trephined is disabling, or later if the wound or the patient’s general condition needs more time.
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What is the syndrome of the trephined?
A cluster of symptoms — headache, cognitive slowing, weakness, mood change, dizziness — that appears after a large craniectomy and is caused by atmospheric pressure and altered brain physiology across the open defect. Cranioplasty often reverses it, sometimes dramatically.
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Autologous bone or a custom implant — which is better?
Autologous bone (your own stored flap) has no implant cost and integrates biologically, but has higher rates of infection and late resorption. Custom implants (PEEK, titanium, hydroxyapatite) give a better cosmetic contour and lower resorption, at higher upfront cost. The right answer depends on your defect, your age, and whether the flap is available and viable.
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How much does a private cranioplasty cost in the UK?
Roughly £12,000–£22,000 for autologous bone, £14,000–£26,000 for titanium mesh or PMMA, and £22,000–£45,000 for a custom 3D-printed PEEK, titanium or hydroxyapatite implant. We confirm firm figures within one working day.
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What are the main risks of cranioplasty?
Infection is the most important — around one in ten cases, higher with autologous bone. Bone flap resorption, seroma, epidural haematoma, seizures, wound dehiscence, CSF leak and unmasking of hydrocephalus are the other complications worth knowing about.
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How long is the recovery?
Two to five nights in hospital, wound review at two weeks, and neurosurgical review at six. Cognitive and functional improvement from reversal of the syndrome of the trephined often continues over three to six months.
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Will the implant set off airport scanners?
Titanium implants can occasionally set off metal detectors, though modern devices are usually fine. PEEK and hydroxyapatite are radiolucent and do not. You will be given a written record of the implant to carry.
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When should I go to A&E after cranioplasty?
Fever, spreading redness around the wound, clear fluid leaking through the scar, skin breakdown over the implant, a new seizure or new weakness are all reasons to seek same-day medical help.
Related treatments
Looking for something else?
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Craniotomy
Opening the skull to access the brain — for tumour, aneurysm or trauma.
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Craniofacial surgery
MDT reconstruction of the face and skull after trauma or tumour.
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All tests and procedures
Every test and procedure we arrange.
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Nerve Conduction Studies
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In practice, in London
The honest picture around cranioplasty in London
For cranioplasty, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. The NHS route for cranioplasty is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For cranioplasty in particular, we bias towards consultants who do this every week rather than every month.
The value of going through a concierge for cranioplasty isn’t access — anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.