We devised a method of making two kinds of silicone elastomer implants from forehead cast models obtained from alginate impressions of the patients' foreheads: the implants are made from the curing of Silastic Medical Adhesive Silicone Type A and liquid silicone rubber which are spread thickly on the cast model. Prefabricated, custom made silicone onlay implants have been implanted in five platients with turricephalic skull deformities. Because these custom made implants have the ventral surface of the exact concave contour conforming to the convex surface of the forehead framework, they blend in nicely with the various configurations of the existing deformed forehead framework, and thus minimize malposition and extrusion. Because these implants also have a rough dorsal surface, they resist migration and capsular contracture. The ease of making this implant coupled with the shortened operative time, minimal hospitalization, and few minor complications offers the reconstructive surgeon another and simple method for treatment of extensive forehead deformities.