Hard knots on the forehead can often be attributed to benign bony growths called osteomas. Osteomas are uncommon, but these benign tumors in the bone of the skull can have a unpleasing appearance, and ;ead tp pain, sight issues. Typically, they are rather slow growing in nature. Other bone tumors are possible and include osteoid osteomas, which can sometimes be distinguished radiologicaly.
The classic approach to the removal of forehead osteomas in an incision along the face. Dr. Shah preference is to recontour the bone of the forehead with the use an endoscope. By making the incision in the scalp, no scar is visible on the face. The instruments Dr. Shah uses to reshape the forehead create an improved appearance and actually feel smoother.
Endoscopic forehead osteoma removal is done on an outpatient basis. Due to Dr. Shah's technique of selectively blocking nerves with local anesthesia, most patients only need minimal anesthetic, allowing for a relatively pain free experience. Many patients are able to return to work either the next day or in a few days.
Osteoma before removal by Dr. Shah (left) and after removal (right)
Frequently Asked Questions
Does Dr. Shah uses staples in my scalp?
No, Dr. Shah believes staples provide an inferior result and places individual sutures to reapproximate the scalp. This makes the incision in the scalp very difficult to see or feel.
Does insurance cover this procedure?
Typically insurance does not cover osteoma removal. However, if there is suspicion that the bony growth is not a benign lesion, than insurance may cover this procedure.
How much does this procedure cost?
The cost varies depending on the size and location of the osteoma, as well as the shape of the hairline.
When can I wash my hair after the procedure?
One day after the procedure
When can I return to work?
Most patients are able to return to work in a day but it varies depending on the type of work (no heavy lifting)
What are some of the risks of the procedure?
Risks include alopecia (loss of hair), sensation issues, step off deformity (scar is not aligned properly). Dr. Shah has not experienced any of these issues in endoscopic osteoma removal.
Can I chose my anesthesia?
Some patients chose local anesthesia, but most prefer a mild relaxing medication during my procedure.
How does Dr. Shah make the bone so smooth?
He uses a variety of instruments to reshape the area then make sure it is smooth to touch and visually.
Can osteomas come back?
Theoretically, an osteoma can come back but none of Dr. Shah's patients have experienced this.
Can Dr. Shah change the shape of my forehead?
Yes, for more information see Forehead Contouring.
Can I leave the Chicago area on the next day?
Many patients are able to fly out on the next day.
Why don't other surgeons use this technique?
Dr. Shah is an innovator in the field and has developed a new approach to forehead osteotomas. In doing so he has helped modified several instruments so that he can approach the osteoma from a narrower incision with the use of narrow, thin endoscopes. This allows him visualization and access through a tiny incision.