Do I need an osteoma removal or forehead contouring/reduction for my forehead bump?

I do these pretty frequently. Make a 1 inch incision at the hairline, elevate right on the bone, chisel the osteoma off, smooth the area with drill (this is contouring but JUST of the osteoma region, not the entire forehead), stitch it closed nicely.  

The treatment for this after  X-rays is an Irregular Trichophytic Incision at your hairline (hair grows thru the scar) and removal of this bump. See a very experienced surgeon who does these procedures routinely. 

That looks like a simple osteoma.  It can be removed via in incision behind the hairline.  They usually chip right off of the forehead bone.  I sometimes use a rasp or small spinning burr to smooth the edges.  You don't need any other "contouring".  

There are a few options available to remove a true osteoma of the frontal bone. Forehead contouring and removal of the osteoma are one and the same. In other words, the end goal is to get a smooth forehead by taking down the osteoma. Incisions can be placed horizontally over the osteoma itself or through a remote incision such as the anterior hairline. The remote incision makes it a bit more difficult to get an excellent frontal bone contour but certainly doable. The horizontal incision in line with natural forehead wrinkles heals amazingly well and gives much better visualization of this area. This ultimately helps get a flatter contour with less risk of complications. I have done both approaches.