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Lets take a moment and realize that it's not possible, as the back end of the shrapnel (Since the max size of the shrapnel would not be more than 90% out of the skull, otherwise removal would only affect his optical nerve and prefrontal cortex and therefore we okay with removal) the entire piece of non-metal would have to seen at the back of the head.
I'm talking Phineas Gage levels of ♥♥♥♥ in your face, it would be poking out both ends if it truly was any kind of shrapnel
Cancerous tumours on the other hand that protrude your skull and affect your brain tissue however couldn't be "Removed" easily.
R&D has done it again! xD
However, all in game sources clearly state it's a hunk of shrapnel, and it IS there in the hospital, and.. No idea what else to say.
Game says it's shrapnel, so it's shrapnel.
Come on....its Metal Gear. There was a ♥♥♥♥♥♥♥ Ghost in MGS 3. Weirder things have occured like the lightning throwing guy from MGS 3 as well.
You missed the opportunity of saying a Helicopter got devoured by a giant fire whale and exploded during the first MGSV TPP mission
That was so odd that it cancelled itself out in my mind. Looked cool though.
The hidden Demon Points gauge has chances of increasing and decreasing, and it all depends on your actions. From what I've seen from leaked guidebooks, the best way to lower Demon Points is by unlocking achievements/trophies. I honestly do not know why.
Other ways to decrease it is extracting wounded soldiers via helicopter, extracting child soldiers (fulton or heli, but the latter has double points than fulton), disposing of nuclear weapons, extracting very rare animals, extracting prisoners, etc.
You can reduce your horn size by doing things that earn you heroism points.
(COPIED FROM OFFICIAL GUIDE (Possible spoiler? Not really? Just being safe here.)
The length of the horn-like shrapnel protruding from Big Boss's forehead is determined by the hidden Demon value, There are three possible sizes. each corresponding to a specidic Demon point milestone
Default Horn...Short<25,000 Medium<25,000-50,000 Long<50,000
1st Change....Short<40,000 Medium<40,000-80,000 Long<80,000
2nd Change...Short<55,000 Medium<55,000-110,000 Long<110,000
3rd Change....Short<70,000 Medium<70,000-140,000 Long<140,000
4th and Last...Short<85,000 Medium<85,000-175,000 Long<170,000
Whenever you hit the "long horn" milestone, Big Boss becomes "Demon Snake". At this point, his outfit is permantly soaked in blood and cannot be washed away if you shower or attempt to bathe in rivers and pools. Even a change of clothes will not remove these perpetual stain (though an exception is made for the special Solid Snake, Cybord Ninja and Raiden costumes you can obtain in late-game unlocks.)
You lose Demon Snake status by performing actions that lead to Demon point reductions that move you back into the "Medium Horn" category. Whenever you transfer between levels -from medium size to small, or from long to medium, all thresholds will increase in the table to the right.
NUKES (THAT PART YOU WERE ASKING)
Of all actions that adjust your Heroism and Demon totals, developing a nuclear weapon has perhaps the most profound consequences. The moment that the manufacturing process is complete, your Heroism score is reduced by -50,000 points and your Demon value increases by +50,000 points. For many players, the latter penalty will instantly transform Big Boss in Demon Snake. You should therefore think very carefully before you commit to researching.
What does the nuke do?
By developping a nuclear deterret, you can prevent rivals from attempting to infiltrate you FOB. Equally you cannot infiltrate the FOB of rivals who posses a nuclear weapon. HOWEVER, THERE IS A CRITICAL EXCEPTION TO THIS RULE: any player who unlocks the "Hero" accolade (by accumulating 150,000 Heroism points) IS IMMUNE to neclear retaliiation and their ability to raid is not restricted.
I can give you a list of mission that will increase/decrease Demon/Heroism is there's enough people here that want it. Hope this helps.
Please do, I'd like to know how to decrease demon points if I ever turn into Demon Snake.