Peri-Eyebrow Incision: A Practical and Aesthetic Solution for Forehead Lipoma Surgery

Area of Science:

• Plastic Surgery
• Dermatologic Surgery
• Surgical Oncology

Background:

• Forehead lipomas present cosmetic concerns, with conventional surgical approaches leaving noticeable scars or being unsuitable for certain patient groups.
• Direct transcutaneous incisions offer easy access but result in visible scarring.
• Hairline incisions conceal scars but are not ideal for patients with baldness, high hairlines, or lower forehead lipomas.

Purpose of the Study:

• To evaluate the efficacy and cosmetic outcomes of a peri-eyebrow incision approach for forehead lipoma excision.
• To compare the peri-eyebrow method with conventional direct and hairline incision techniques.
• To identify predictors for selecting the peri-eyebrow incision, particularly the vertical ratio of lipoma location.

Main Methods:

• Retrospective review of 176 patients undergoing forehead mass excision, with 97 biopsy-proven lipomas analyzed.
• Classification of lipomas based on location (peri-eyebrow, hairline, direct) and measurement of vertical ratio.
• Logistic regression and Receiver Operating Characteristic (ROC) analysis to determine predictors of peri-eyebrow incision use.
• Scar quality assessment using the Patient and Observer Scar Assessment Scales.

Main Results:

• The peri-eyebrow incision was exclusively used for midline or median lipomas with the highest vertical ratio (0.70 ± 0.10).
• Vertical ratio independently predicted peri-eyebrow incision selection (adjusted OR 3.32 per 0.1-unit increase, p < 0.001), with an optimal cut-off of 0.615 (AUC 0.872).
• Peri-eyebrow and hairline incisions yielded significantly superior scar quality scores compared to direct incisions (p < 0.001).

Conclusions:

• The peri-eyebrow incision is a safe and cosmetically advantageous alternative for forehead lipoma removal.
• This approach effectively conceals scars and provides outcomes comparable to hairline incisions.
• It is particularly useful when hairline incisions are contraindicated due to patient factors or lipoma location.