An intra-oral approach to facial skin lumps—a move towards scarless surgery

The aim of surgical management of benign facial skin lumps is to remove the lesion in its entirety, with minimal damage to adjacent tissue structures, while maintaining facial aesthetics. A method to achieve these goals is to remove peri-oral lesions in the labial and buccal zones via an intra-oral approach. We report an extended cases series of facial skin lumps that were excised using an intra-oral approach. A retrospective analysis was performed on all patients who underwent excisions of benign cutaneous lesions on the face via an intra-oral approach. Patient demographics, indication for surgery and complications were noted. Forty-seven lesions were excised over a 15-year period. Indications for surgery included benign lesion with minimal skin involvement, risks of keloid/scar hypertrophy and cosmetic factors. Lesions were predominantly epidermoid cysts and lipomas. Mean follow-up was 2.9 years with a 6.4% recurrence rate and 2.1% rate of haematoma and transient facial nerve weakness. There are established techniques to remove facial skin lumps. We believe that in selected cases, an intra-oral approach to such lesions, particularly in cases with high risk of scar pathology or where there is strong patient preference, may be an important tool in the oral and maxillofacial surgeon’s armamentarium.