Can Forehead Lipoma Be Removed Without Cosmestic Surgery?

Question

1.5"  Diameter Lipoma Center Forehead. 

	Dermatologist sent me to Plastic Surgeon who says I need to have head shaved and an insertion made in hairline to remove lipoma. Another Dermatologist told me to have the tissue liposuctioned. Thanks. Dan

Sirius K. Yoo, MD · Answer

Forehead lipomas can be removed in several ways.  The traditional 
technique is to place an incision directly over the lipoma.  This 
obviously leaves a visible scar on the forehead.  The second technique 
is to place an incision right at the hairline or immediately behind it 
to create access. This open procedure results in a fairly long incision 
and at least temporary numbness behind
 the incision.  This is the same type of incision that we use for 
browlift procedures.  The least invasive and most modern technique is 
endoscopic removal.  With this technique, small incision are made behind
 the hairline and endoscopic instruments are used to remove the fatty 
tumors.  Usually two separate 2 cm incisions are made about 1 cm behind 
the hairline.  The procedure and recovery are nearly painless.

Raffy Karamanoukian, MD, FACS · Answer

Lipomas are benign fatty tumors that occur under the skin and less commonly within the muscle. They are associated with mild discomfort and a lump underneath the skin. It is always best to talk to an expert plastic surgeon to determine whether the lipoma is possibly a cyst or a tumor or hernia. We would have to remove the lipoma to be sure that it is not something else and we usually do this by sending it to a pathologist for evaluation. If a lipoma is painful, then an exam is needed to make sure it is not compressing on a nerve or whether the diagnosis is different. Aftercare for a lipoma includes gentle compression and Plato’s Scar Serum twice daily on the wound.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Michael Constantin Gartner, DO · Answer

Lipoma  of the forehead cannot be removed without surgery. liposuction has the risk of leaving irregularities and a higher recurrence rate.Best Regards,Dr. Gartner

Anil R. Shah, MD · Answer

Hello,Lipoma removal on the scalp can be removed and is not dangerous if it is in fact a lipoma.  Rare cases of fatty tumors have been described.  Most often it is removed under local anesthesia comfortably and best to have a lipoma removed with a minimal incision.  
Best,
Anil Shah

Houtan Chaboki, MD · Answer

Lipomas are typically removed with surgery, to ensure complete removal and to allow the tissue to be sent to the pathology laboratory for testing. Facial plastic surgeons can help remove lipomas with small or hidden incisions that usually heal well. Liposuction is generally not recommended for lipomas. Only after a comprehensive evaluation can a specialist help determine appropriate options for you. Best of luck.

	Dr. Chaboki

Damon B. Chandler, MD · Answer

From your single posted photo this does appear to be a forehead lipoma. I always recommend sending any removed specimen to a dermatopathologist to obtain a precise diagnosis. I would not recommend liposuction to remove this growth. Though an endoscopic approach from the scalp could be considered this would not be my first choice. I have removed many of these with a careful incision placed in a natural forehead crease directly over the lipoma. Patients typically heal with a small scar which fades with time and they are thrilled with the removal of the large lump that was previously there. You may always have a small depression or contour irregularity after the lump is removed, especially when it is as large as yours. But I believe you should be able to have a very nice result with traditional surgical removal of that lipoma.
Please chose a board-certified MD Oculofacial Plastic Surgeon or Facial Plastic Surgeon for your procedure as they are expertly trained in forehead lipoma removal.  Your surgeon should be able to provide you with some reassurance as well as guidance in the care of your healing wound. Any mole or lipoma removal may leave some scar, discoloration, or skin surface irregularity, but typically any scarring or redness fades substantially with time.  Many patients travel great distances to see me for my expertise in this sort of plastic surgery and I have treated thousands of face moles, cysts, keratoses, and lipomas. Please be realistic that any method of removal may leave some color changes, scarring, or forehead contour irregularity or depression that can take 6 months to a year to heal fully. Good luck in your search!
Damon B. Chandler, MD
Harvard-Penn Trained Oculofacial Plastic Surgeon

Jordan Rihani, MD · Answer

Hello Paco, Thank you for your question. Lipomas of the forehead are fairly common. The most simple way of removal requires an incision over the lipoma. This unfortunately can leave a scar and depending on the location can leave the forehead numb for some time. I typically perform these types of cases using small incisions behind the hairline allowing me to remove the lipoma endoscopically. I do not shave any hair for the procedure. This allows all incisions to be hidden behind the hairline and oftentimes there is no numbness after the procedure.

Tom J. Pousti, MD · Answer

Thank you for the question and picture.

	Direct excision of the lipoma  with a transverse incision above the lesion is a relatively straightforward procedure. I would agree that it is your best interests to have it directly excised  as opposed to having liposuctioning performed.

	Best wishes.

Peter A. Aldea, MD · Answer

As young surgeons we are taught to first diagnose and then select a treatment. Although your assumption that this is a fatty benign tumor (lipoma) is probably correct, it COULD also be another tumor such as a sebaceous or an inclusion cyst or in rare cases something rarer or even a malignancy. The ONLY way to precisely tell what this is is to have a representative piece examined microscopically by a pathologist. This would require removal or a biopsy.

	If we play the odds that it is a benign tumor and want the forehead flattened, the mass must be removed. It cannot be flattened nonsurgically. The question then becomes how to best do so. If you are not accepting of a scar hidden in your horizontal wrinkle lines which would allow complete removal of the mass, then the only solution is to place a tiny incision in the hairline and liposuction this out. I have done this with great results but I always warn my patients that the mass may come back and that IF the pathology comes back as cancer, we have significantly complicated matters by removing it from a distant incision. This has not turned to be the case.

	Good Luck.

	Peter a Aldea, MD
	Memphis, Tennessee

Timothy Mountcastle, MD · Answer

it can be removed directly with an incision over the lipoma by any surgeon.

	you will just a have a faint scar on your forehead.

	if you want it removed via the scalp without the forehead scar you will probably need a plastic surgeon

	you dont have to shave though. i do this all the time without shaving.

	if done with an incision directly over lipoma on forehead it takes me 10 minutes under local anesthesia in the office to do it.

	the no scar way takes a bit longer and needs to be done in the o.r.

	 

	liposuction dont do. it wont work.

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