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The co-operation among plastic surgeons and computer experts is presented demonstrating the reconstruction of a cranial bone defect of a patient. The adequacy of manufactured implant for reconstruction of cranial bone defect on the base of classic methods in only approximate. Computer aided design is needed for creating a more sophisticated implant. Cranial CT is digitised and a 3 dimensional model is created. The precise implant, manufactured by a computer directed milling machine, fits ino the bone defect. During the operation the cranial bone defect is explored, the bone edges are identified. The implant is fixed and the skull skin is closed. The authors demonstrate a successful operation of a cranial bone defect of 9 x 6.7 cm, the complicated shape and bone surface was reconstructed by a computer aided and manufactured implant. The co-operation of plastic surgeon and computer experts are essential during the process of implant design. The computer assisted and manufactured implants are suitable for the most sophisticated functional and aesthetic reconstruction of bone defect with complicated surface and irregular pattern.
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