Holger G. Gassner, M.D., Board Certified Facial Plastic Surgeon (USA)

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Lipomas, Osteomas, non – resorbing Fillers and other lesions may show on the forehead or cheek and appear as lumps. The traditional way of removing such lesions is through an incision in the external skin, which leaves behind a scar. The endoscopic method first described by Dr. Gassner allows to remove forehead lesions without a visible scar. The incision line is placed in the hair bearing skin behind the hairline. For cheek lesions, the incision is placed through the mouth in the gum line.

Lipomas and osteomas are benign lesions that grow below the skin of the forehead or cheek. They usually appear as lumps that slowly grow larger. Lipomas originate from the fatty tissues below the skin and are soft to touch. Osteomas originate from bone and are firm to touch. Both lesions are usually benign, but continue to grow. Less frequent lesions include fillers that do not resorb and / or have created a foreign body reaction; neuromas, cysts, and adenomas. For all soft tissue lesions, histologic diagnosis is obtained in order to verify the diagnosis.

You may schedule a video appointment with Dr. Gassner in order to discuss your treatment. Dr. Gassner will inform you, if you need additional studies or tests to prepare for your endoscopic procedure. Often, your personal consultation with Dr. Gassner can be scheduled for the day preceding your procedure.

Traditionally, forehead lesions have been removed through an open incision on the forehead skin, which results in a visible scar. As a minimally invasive alternative treatment, Dr. Gassner was the first to describe the endoscopic resection of forehead lesions through an incision behind the hairline. With this technique, lipomas and osteomas of the forehead are removed without visible scars. The short endoscopic incision is placed in the hair bearing skin. The lesion is then visualized with the use of endoscopes and removed. Using a similar technique, the endoscope is introduced into the mouth to access lesions of the cheek. The procedure is usually performed outpatient and under sedation.

The procedure is ambulatory and patients can often go back home the same day or the following morning. In case of a forehead lesion, a circular dressing is applied, which may be removed the following morning. Sutures may be removed by a doctor locally. Recovery should be quick. In cases of high forehead osteomas or lipomas, patients are often inconspicuous and able to return to work after two days. When there is a lipoma located lower on the forehead or the cheek, or if the lesion is larger, some bruising and swelling may develop with a maximum on day 3 to 5 after the procedure.

Dr. Gassner was the first to describe the endoscopic removal of forehead lesions in the early 2000s at the Mayo Clinic. He initiated and co-authored a large mutli-center study on the subject. His patients travel internationally to get their facial lesions removed through the ecarless, endoscopic method.