Q : I have a bump at the front of my head. I would like for it to go down a bit. Please help me. Thanks.
A: Bumps on the forehead are not rare and are commonly seen by plastic surgeons. While the exact diagnosis can be varied, the usual suspects are either bone-based (osteoma) or of soft tissue origin. (lipoma) Feeling the bump can usually help one distinguish between the two. If in doubt, a CT scan can easily tell which one it is.
If the bump is hard and doesn’t move it most likely is a classic osteoma. These are benign bony growths that develop slowly. For many patients the exact origin is unknown. They can develop after being hit on the forehead, particularly if a bruise or hematoma resulted. It is thought that bleeding under the periosteum serves as a nidus to stimulate the laying down of bone.
Removal of forehead osteomas is traditionally done through an overlying horizontal skin incision. In an older patient, this can be skillfully placed in an adjacent wrinkle and the scarring can be quite minimal. In patients without a close wrinkle or few wrinkles, the scar is not as appealing. In most casesw of forehead osteoma removal, I prefer the use of an endoscope to recontour the bone of the forehead. By placing the incision in the hair, no visible scar is left on the face. Osteomas can usually be made to pop right off the bone by using a small chisel. Through two endoscopic incisions, the scope and the osteotome can be simultaneously used.