ENDOSCOPIC (SCARLESS) FOREHEAD LUMP REMOVAL

INTRODUCTION

  • Forehead lumps are fairly common. They can cause substantial social embarrassment and also physical discomfort which certain headgear.
  • The nature of these lumps can be :
    • Lipoma
    • Osteoma
  • Lipoma :
    Forehead lipoma - best removed by scarless endoscopic method Forehead lipoma
    • Benign (non-cancerous) abnormal collection of fatty tissue growth within a thin fibrous capsule.
    • Can be found in almost any part of the body.
    • Complete removal is achieved when the lipoma is removed with the capsule.
    • Usually soft, but over the forehead, lipoma tend to be deep and may feel firm.
    • Usually does not resolve by itself. Treatment is by surgical removal.
  •  Osteoma :
    • Benign (non-cancerous) bony growth. Usually 1-2 cm in diameter. Feels bony hard.
    • Can be found in many parts of the body.
    • May be painful in some cases.
    • Usually does not resolve by itself. Treatment is by surgical removal.

 

OPEN (TRADITIONAL) VS SCARLESS (ENDOSCOPIC) FOREHEAD LUMP REMOVAL

 

Table Of Open (Traditional) vs Scarless (Endoscopic) Forehead Lump Removal

Open (Traditional)Scarless (Endoscopic)
Skin cut
Open Technique of forehead lump removalOpen Technique of forehead lump removal

Direct skin cut over the lump

Endoscopic (Scarless) Forehead Lump Removal - no visible scar Endoscopic (Scarless) Forehead Lump Removal – no visible scar

Two skin cuts hidden behind the hairline in the scalp.

Scar visibilityScar may be pigmented in dark skin individual. Scar may blend with forehead wrinkles in older patient, but more visible in younger patient.Scar hidden by the hair.
TechniqueDirect cut and removal of lump.Special equipment needed. A video endoscopic guide another cutting instrument to remove lump remotely.
Patient SatisfactionAverageUsually much better.

 

SUITABLE CANDIDATES

  • Most patients are suitable for the technique except for those with receded hairline.

 

DESCRIPTION OF PROCEDURE

Endoscopic (Scarless) Forehead Lump Removal - no visible scar Endoscopic (Scarless) Forehead Lump Removal
  • Tumescent fluid is injected in the forehead around the lump to help separate the tissue layers.
  • Two small skin cuts (incisions) are made behind the hairline in the scalp.
  • Video scope is inserted to visualise the lump.
  • Another instrument is inserted via the second scalp incision to remove the lump under visualisation of the video scope.
  • Additional instrument may be needed to chisel or burr down a bony osteoma.
  • The procedure is usually completed within an hour.
  • Secure forehead bandaging is applied.

 

ANAESTHESIA

  • Intravenous sedation or general anaesthesia.

 

POST OPERATIVE CARE

  • Patient may go home the same day or stay overnight in the hospital.
  • Forehead bandaging to be worn for at least 3 days to reduce risk of bruising over the forehead and around the eyes.
  • Swelling and bruising usually resolves within about 2 weeks.
  • Avoid exertion and rest 30 degree inclined for optimal recovery
  • Apply antibiotic ointment to scalp wound regularly 3-5 times a day
  • Pain is usually minimal and well controlled by oral medications

 

RISK AND COMPLICATION

  • Bleeding and forehead haematoma (blood clot accumulation) (Risk minimised by adequate forehead bandaging)
  • Small area of scalp numbness may take a few months to resolve.

 

 

FREQUENTLY ASKED QUESTION

 

Why do patient still choose scarless (endoscopic) forehead lump removal despite increase cost ?

Most patients would choose to avoid a scar over an otherwise flawless forehead whenever possible. The recovery time is comparable with the open technique, but the patient satisfaction level is much higher for the scarless technique. The patients who choose the open technique do so usually because of cost consideration or because they were not told of the scarless (endoscopic) option.

 

After the consultation, Dr Ng will assess if the forehead lump is a lipoma (fat) or osteoma (bone). He would recommend the best surgical option for forehead lump removal : either endoscopic scarless forehead lump removal or direct open method. If financial situation permits, the best choice remains scarless forehead lump removal and this would also be the recommendation of top plastic surgeons in Korea or around the world.