(A412) Endoscopic Forehead Lipoma Excision: Techniques for Success and Pitfalls to Avoid

Introduction: Endoscopic resection of forehead lipomas is preferred for minimizing visible scars. With accessible techniques, avoiding scars is more feasible. Success depends on patient-specific considerations, correct plane dissection, and proper retraction, thus facilitating efficient lipoma removal and wide forehead access. This paper details our technique, highlighting its smooth, nearly bloodless nature while avoiding common pitfalls.

Methods: The procedure starts with assessing the patient's hairline. The pretrichial approach suits patients without baldness or recession. Alternatives like transbrow or temporal pretrichial are considered for recessed hairlines, though challenging for medial lesions. Vasoconstrictive agents are injected around the lesion. Incisions are made, extending dissection to the subgaleal plane. A retractor creates space for endoscopic instruments. Fixed retractors or robotic arms are often used for suspension. Forehead lipomas are typically associated with frontalis diastasis and easily identified; the lesion is then dissected with a Freer elevator. A multilayer closure is completed.

Results: Our series shows how forehead lipomas are removed through a relatively bloodless procedure with minimal scarring. Otolaryngologists efficiently perform these due to their unique endoscopic skills. Optimal retraction allows excellent visualization, reducing wiping. Major neurovascular structures are protected, and the procedure is completed within standard timeframes while enhancing cosmetic outcomes.

Conclusions: Endoscopic excision of forehead lipomas using an endoscopic approach is nearly bloodless and protects neurovasculature. Our technique, with proper retractors and subgaleal plane dissection, ensures smooth removal with minimal cosmetic impact.