Can You Remove a Forehead Lipoma Through the Scalp or Hairline to Hide the Scar?

Question

I had a head injury when I was 14, now 21 I still have what I researched to be a Lipoma. It is rather small but I was considering having it removed by a plastic surgeon. It is only about half an inch below my hairline and I was curious to know if the incision can be made where the hair grows to mask the scar. Thanks!

Kevin M. Robertson, MD, FACS · Answer

The answer is yes, you can camoflage the incision if it's only a half an inch away. Lipomas are pretty straightforward to dissect and remove, and can be approached through small incisions. Liposuction can also be used for very select lesions, although I suspect not for this size and site. Discuss your concerns with your surgeon.

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

The preoperative assessment is important in forehead lipoma removal. I would recommend an incision in the hairline or along a wrinkle crease. This minimizes surgical scarring.

Thomas A. Lamperti, MD · Answer

Yes, forehead growths can be removed using incision(s) hidden in the hairline. This is more straightforward the closer the growth is to the hairline (as is appears to be in your case). Visiting with a surgeon experienced in operating in this area would allow for more detailed assessment.

Randy Wong, MD · Answer

Lipomas are easy to remove by direct approach with care to place the orientation of the scar with the skin lines. There is more of a technical challenge to approach it by tunnelling but certainly worth the result of a hidden scar. I would consider the use of a small bore liposuction cannula, but be aware of the slightly higher risk of recurrence using the latter techniques. I have been successful in flattening a forehead lipoma by injection of a sclerosant and steroid mixture, but there is less predictability of result using chemical methods.

Matthew Schulman, MD · Answer

As plastic surgeons, our priority is to leave as little scarring as possible. This often means "taking the long road" by keeping the incisions in a hidden area, even if it means using small cameras to help. Obviously, I would need to see your lipoma, but it sounds as if this can be removed through a well hidden incision behind your hairline.

Tom J. Pousti, MD · Answer

Based on your description, an incision can be kept at or above the hairline to access the lesion.

	Best wishes.

Barry L. Eppley, MD, DMD · Answer

Any lipoma on the forehead has the potential to be removed through a scalp or endoscopic approach. The closer they are to the frontal hairline, the easier they are to do. Two small scalp incision are used to endoscopically remove a forehead lipoma, somewhat similar to that of the laparoscopic removal of the gallbladder. It can also be removed through a direct incision if one has deep forehead wrinkles without creating a new 'scar line'. (we can call a wrinkle an old scar line)

Jessica J. Krant, MD, MPH · Answer

I actually wrote the textbook chapter in Surgery of the Skin, 1st Ed., regarding the removal of a small, high forhead lipoma, through an incision hidden in the hairline. It is possible, but definitely technically more difficult than a small direct incision over the lipoma itself. Go to a skilled dermatologic or plastic surgeon for this procedure. Don't be surprised by a small amount of scalp numbness or tingling for a few weeks after the surgery, as some small skin nerves can be cut, but will regenerate.

Samir Shureih, MD · Answer

One needs to evaluate you and the position of the lipoma from the hairline. The thickness of your hair.

	You also run the risk of a wide scar with no hair which requires revision.

	Most lipomas of the forehead are under the muscle, The forehead can be exposed through an incision in the hailine, but the incision may be a long one.

Can You Remove a Forehead Lipoma Through the Scalp or Hairline to Hide the Scar?

Answers (10)

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