Forehead soft tissue nodule not lipoma? (Photo)

Question

I've had this lump on my forehead for about 10 years. I believe it was trauma induced. I consulted with my PCP who did a CT scan and stated it was a soft tissue nodule with no bone involvement. I was then referred to a plastic surgeon who stated it may be a lipoma. I underwent the procedure, but the surgeon stated he did not see any lipoma to extract. The lump still exists now with more scar tissue. Are these easily missed? Could the lump just be scar tissue from injury? Any help would be great

Robert M. Lowen, MD · Answer

In this case, I would get an MRI to confirm the presence or not of a lipoma. Their signature on MRI is pretty diagnostic.  Once confirmed, re-operation would be reasonable.  You might then have your original or another board-certified plastic surgeon re-operate. For reasons other surgeons have listed, the lipoma might have been missed during the first operation.

Nelson Lee Novick, MD · Answer

Sorry you are having this problem. Quite correctly, your physician sent you for a CT evaluation prior to any surgical intervention. CTs and ultrasounds are typically pretty good in making sure that the lump does not relate to underlying bone or nerve problems. If scar tissue is playing a role in the bump, the injection of an anti-inflammatory agent may help to shrink it and make it much less visible, used either alone or in combination with a small amount of hyaluronidase.  If a deeply located lipoma is the culprit, Kybella, rather than repeat surgery, may be considered to inject it and shrink it (although this is a completely off-label use of this product, which is approved for treating submental--double chin--fat deposits). At this point, you might consider  seeking a second opinion. Best of luck.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph and I am sorry to hear of your soft tissue mass that has persisted for 10 years.  In most instances a CT scan or ultrasound should provide the appropriate diagnosis as the tissues are thin enough to allow excellent resolution. Though nothing replaces an in-person examination I would seek a second opinion as a lipoma looks likely.  Hope this helps.

Benjamin Caughlin, MD, FACS · Answer

Without a physical exam it is difficult to give you a good answer. That being said, lipomas have very typical characteristics on CT scan and if the surgeon reviewed the scan I bet he got it right.

They can be hard to find. With your history of trauma scar tissue is also a real possibility.

Also a simple epidermal cyst is probably the most common lesion in this location.

It is difficult to appreciate in the photo but it if does not bother you cosmetically watchful waiting is another option as the CT scan and surgeon analysis both suggested a benign process.

Hope this helps.

Best of luck,

DrC

Michael I. Echavez, MD · Answer

Sometimes lipomas on the forehead can be below the muscle.  I am not certain if your surgeon went that deep to look for a lipoma or not.  Was anything removed at the time of your surgery?  It is possible it could be scar tissue, but normally this could be removed as well.

Forehead soft tissue nodule not lipoma? (Photo)

Answers (7)

Answer: Lumps and bumps

Answer: Lumps and bumps

Answer: Forehead mass

Answer: Forehead mass

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Forehead soft tissue nodule not lipoma? (Photo)

Answers (7)

Answer: Lumps and bumps

Answer: Lumps and bumps

Answer: Forehead mass

Answer: Forehead mass

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Recommended reading

Everything you need to know about Lipoma Removal

Our mission is to create a world where every investment in modern beauty is Worth It.