 This study presents the experience of the author with skull reconstructions using custom PMMA prostheses in 14 patients who underwent decompressive craniactomies between 2014 and 2015. The results showed that all patients experienced improved symptomatology, aesthetic improvement and expansion of the brain after surgery. The use of prototypes to customize cranial prostheses facilitates the operative technique and enables patients to develop a nearly normal cranial contour. This article was authored by Pablo Marisevich and Anna Carolina Campolina.