Face And Scalp Osteoma Treatment

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Osteoma Treatment in Atlanta

Osteomas, lipomas, cysts, and various other “bumps” on the scalp, face, and neck are common concerns among patients who come to our practice.  An osteoma is a benign (not cancerous) bony growth which can appear as a hard, fixed knot or bump on the forehead or scalp, though osteomas can sometimes develop within the sinuses as well.  An osteoma of the forehead or scalp typically feels like a raised, solid bump which is firmly affixed to the underlying bone. While one can move or slide the skin and tissue over the bump, the osteoma itself cannot be moved or shifted.  Osteomas usually develop slowly over time, and most commonly present in a person’s 20-40s. While they are most frequently solitary, it is not unusual for a patient to present with multiple osteomas.  Usually asymptomatic (or not causing symptoms), osteomas rarely cause pain or discomfort and most commonly bother people by their appearance.  While no one cause has been definitely identified for the development of osteomas, the most commonly accepted scientific theories point to genetics and trauma as possible causes.

How is an osteoma treated?

Our facial plastic surgeon Dr. Inessa Fishman most commonly treats osteomas via a minor surgical procedure; she performs osteoma surgery in the office (with local numbing medicine) or in the operating room with the help of general anesthesia.  The size and location of the osteoma or osteomas help Dr. Fishman design a specific treatment plan; the vast majority of the osteomas Dr. Fishman removes are treated with the help of local anesthesia and relaxing laughing gas (called ProNox), in the office. 

After freezing the area of treatment with numbing medicine, Dr. Fishman places an incision directly on top of the osteoma or behind the hairline for osteomas within the forehead or scalp.  She dissects and “shaves down” the bump of the osteoma, then carefully closing the surgical incision for the best cosmetic outcome. The scar after osteoma surgery usually heals very well over time; while the incision never completely disappears, it can be difficult to notice when well-healed.  Most scars are hidden within the hair-bearing scalp or the natural expression lines of the face, allowing for excellent scar camouflage.

What are the benefits of osteoma surgery?

  • The main advantage of osteoma treatment is getting rid of the associated bothersome “bump” or mass.  Most patients are relieved of having to camouflage the bump of the osteoma with their hair.
  • Lots of patients feel better after getting the benign diagnosis of osteoma after pathology analysis of the removed tissue.
  • Osteoma excision surgery is usually associated with little downtime and minimal discomfort.

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What can I expect after osteoma treatment?

Immediately after treatment, you will likely notice some swelling, numbness, bruising, and paleness about the treated area.

The numbing medicine wears off over a few hours after treatment; post-treatment, you may have some discomfort, which should be controlled with cool compresses and oral pain medications like Tylenol and Motrin.

While swelling is common and normal after osteoma surgery, cool compresses can help minimize both swelling and discomfort, and should be used on the treated area as instructed.

You may have a compressive headwrap dressing placed after surgery; when placing this dressing, Dr. Fishman generally recommends removing it after ~24 hours.

You should be able to bathe and shower—and wet your incision—approximately 24 hours after treatment.

Stitches are usually removed at 7-10 days after surgery.  Out-of-town patients usually receive absorbable sutures which do not require removal.

Depending on your health, medical history, and recovery, you should expect to be presentable (and return to work and social activities) in a few days to 1 week after treatment

Frequently Asked Questions

Any mass or “knot” that develops on the scalp, face, or neck should be carefully examined by one’s physician.  Because osteomas are relatively common and have a classically firm and fixed feel, they are typically diagnosed on physical exam; occasionally, patients may undergo imaging (such as a CT or “CAT” scan) or biopsy to diagnose an osteoma.  Dr. Fishman usually discusses her imaging preferences for suspected osteomas with patients as part of her consultation.  Surgically removing or excising a bump can be both curative and diagnostic—in that the tissue removed undergoes pathology analysis to yield the diagnosis of osteoma, or something else.  Men and women in good health and bothered by the appearance of a mass or bump within the head and neck may be good candidates for osteoma treatment, including excision surgery.  If you are bothered by a bump at your face or scalp, consult with Dr. Fishman about your treatment options.

Most head and neck osteomas at Aviva Plastic Surgery are treated with the help of relaxing laughing gas (called ProNox) and injectable numbing or freezing medicine, though Dr. Fishman will discuss her anesthesia preferences during your consult. Overall, she uses local anesthesia, deep sedation, or general anesthesia for forehead and scalp osteoma surgery, deciding on the best approach after a thorough consultation and analysis of the bump’s location.

Dr. Fishman usually treats most face and scalp osteomas over 1 to 1.5 hours, depending on the amount of work to be done and other associated procedures.  Most patients undergoing treatment of an osteoma with local anesthesia can expect to be in the office for 1.5-2 hours; this time includes discussing any pre-treatment questions, reviewing the consent forms for treatment, taking pre-treatment photographs, receiving the ProNox laughing gas and freezing medicine, undergoing the osteoma procedure, and recovering.

Any surgery that involves cutting through the skin leaves scars, and we take pride in providing effective treatment with essentially inconspicuous scars.  While osteoma surgery leaves scars, these are usually thoroughly hidden in the hair-bearing scalp or the natural forehead creases or facial expression lines.  These scars fade significantly over time and are difficult to find once healed.  Dr. Fishman takes pride both in designing small, inconspicuous scars and ensuring their best healing over time.

Most of Dr. Fishman’s osteoma treatment patients describe a bruised or sore sensation, or a headache, after surgery, with most discomfort fading away within 1-2 days after treatment.  Most people will have mild-moderate discomfort (like a dull ache) which is well managed with cool compresses and oral pain medications (such as Tylenol and Motrin).  Some patients may develop mild bruising after surgery, which usually resolves over 3-5+ days.  Temporary numbness and itching about the treated area are very common, and resolve over the course of several weeks to months in the vast majority of patients.

Dr. Fishman and her staff send the tissue removed during osteoma treatment for pathologic analysis, using one of several certified and highly experienced Pathology laboratories in the Atlanta area.  Pathologic analysis provides a more certain diagnosis than a physical exam and radiologic imaging, and can differentiate between osteomas, lipomas, cysts, and more rare reasons for “bumps.” 

Health insurance plans may cover the removal of osteomas causing pain or other functional symptoms, such as sinus problems.  Health insurance plans do not typically cover the removal of osteomas for appearance or cosmetic reasons.  It is best to check with your insurance provider regarding the details of your healthcare plan. For non-insurance cases, we offer financing options and are happy to discuss this with you after your consult with Dr. Fishman.

An approximate cost for osteoma removal surgery in our practice is $2,800-4,000.  Costs vary based on individual patient needs and other procedures being performed concurrently.  For your individualized treatment plan and pricing information, please contact us to schedule your consultation.  For financing options, learn more about our financing resources.

Osteoma excision post-procedure instructions

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  • Take Tylenol 500mg by mouth every 4 hours for the first 2 days after your procedure; this helps to decrease soreness and discomfort. 
  • Take Motrin 400mg by mouth every 6 hours for the first 2 days after your procedure; this helps to decrease soreness and discomfort. 
  •  You may apply cool compresses to your forehead or area of treatment every 1 hour as needed for discomfort.  Do not use ice directly on the skin; instead use a gel pack or clean washcloth wrung out in ice water.
  • Sleep with your head elevated above the level of your heart for 3-4 days; this helps to promote faster resolution of swelling.
  • If Dr. Fishman has placed a tape dressing onto your incision and stitches, do not remove this until your follow-up appointment or as otherwise instructed.  In general, incisions in or close to the hair-bearing scalp are left without tape dressing.  If you received a compression dressing, please remove this ~24 hours after your treatment unless instructed otherwise.  You may get in the shower and wash your face and hair ~24 hours after treatment.  You may allow water, shampoo, and facial cleanser to run over your incision and/ or dressing; pat dry the incision and/ or dressing after showering. 
  • Avoid lotions, moisturizers, and creams on the incision and/ or tape dressing until you return to see Dr. Fishman. 
  • Know that itching, tightness, and some patchy numbness are normal for several days to weeks after your treatment.
  •  Return for your follow-up appointment in 6-7 days after treatment; you should expect to have stitches removed and for Dr. Fishman to examine you at that time.
  • Please call our practice with any questions or concerns.  Please notify us should you develop a fever greater than 101.5 degrees Fahrenheit, spreading rash or redness, sudden swelling, bleeding, increasing pain, or any other concerns.

Are you ready to do something about a bothersome bump?  Schedule your consultation with our facial plastic surgeon Dr. Fishman today!