Lump on face - options for dealing with fat in infraorbital region w/o definitive encapsulation? (photos)

This is a great question and a somewhat challenging case. I think perhaps the most important first step is ensuring this is not something more concerning. A biopsy could potentially help with this. The next question would be how to best address this area. If it is truly benign (which is most likely), then any approach would need to have low risk for scarring, as I imagine you wouldn't really want to trade a lump for a big scar. I think the best approach in my mind would be a transconjunctival incision (inside of lower eyelid) similar to the approach to a lower blepharoplasty. This limits any incisions on the skin and any potential scarring. It can also be performed at the same time as a blepharoplasty if that is ever something you would be interested in.
I hope this helps!Kyle Kimura, MD Facial Plastic Surgeon

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