Lipoma removal on my forehead, horizontal cut VS vertical cut? Surgeon VS Dermatologist who deals with cancer? (photo)

Question

the Surgeon wants to do a Horizontal cut on my forehead and said it has to be done in the hospital. and stated that there can be permanent nerve damage and my eye could possible droop. the Dermatologist said to do a vertical cut from my forehead to just above my eye lid, as a Horizontal cut would cause my right eye brow to be pulled up permanently. since the Lipoma may be attached to my scull there is a possibility that i could lose feeling in part of my forehead . any advise how to proceed

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph. If your contour irregularity is definitely a lipoma there are many ways to approach removal.  My preferred method would be an incision behind your hairline so as to avoid any scar on your forehead.  If you do not mind a small scar, then I would definitely advise placement horizontally along one of the creases already present to make it as unnoticeable as possible.

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 I. Echavez, MD · Answer

I would definitely use a horizontal incision to remove a lipoma on the forehead.  The reason for this is that the scar, when fully healed, should appear like a forehead wrinkle rather than a noticeable scar.  I normally would remove a forehead lipoma in the office with just local anesthesia, but each surgeon will have his or her own preference.  Your lipoma should be able to be removed without having to remove any skin, so it should not cause your eyebrow to be pulled or moved.

Leslie Memsic, MD, FACS · Answer

A horizontal incision along the natural folds of your forehead is generally the most cosmetically favorable way to remove a forehead lipoma. It should be a small as possible. Lipomas occasionally develop below the muscle (although are generally located under the skin above the muscle), and can be teased out without major dissection of the scalp or skull. Good luck and take care.

Benjamin J. Cousins, MD · Answer

Thank you for your post. I would use a horizontal incision to remove the mass. Be sure to see a Board Certified Plastic Surgeon for your evaluation and surgery. Hope this helps.Sincerely,Dr. Benjamin J Cousins MDBoard Certified Plastic Surgeon

Lipoma removal on my forehead, horizontal cut VS vertical cut? Surgeon VS Dermatologist who deals with cancer? (photo)

Answers (7)