Doctors could have covered the breach with the original piece of her skull, which she has carried under her skin since October, where a surgeon in Pakistan implanted it for safe keeping.

That's a common procedure to preserve bone fragments for later use, Rosser said.

But her own skull section would have no longer fit properly without the addition of some titanium parts, as her head and the bone fragment have changed.

Titanium also has a low incidence of infection and can be handcrafted to near perfection, doctors told her.

"It was Malala's final decision," Rosser said. She picked the titanium plate.

She will also receive a cochlear implant to restore hearing to her left ear, in which she is currently deaf. The gunfire broke the delicate bones that help turn sound into sensory impulses to the brain.

The device will not allow her to hear completely naturally but will restore enough function to the damaged ear to allow her to hear in three dimensions, which is important for safety. It will allow her, for example, to hear an approaching car, Rosser said.

Malala also recently had surgery to reroute a facial nerve that was damaged in the attempt on her life, leaving part the left side of her mouth listless.

"There is a very good chance after this procedure that within a year to 18 months, this will completely recover," Rosser said.

She will then hopefully regain her old smile.