Name of the Procedure:

Excision of Tumor, Soft Tissue of Face and Scalp, Subfascial (e.g., Subgaleal, Intramuscular); Less than 2 cm

Summary

In this procedure, a surgeon removes a tumor from the soft tissue under the fascia in the face or scalp. The tumor is less than 2 centimeters in size and could be located beneath the galea (subgaleal) or within the muscle (intramuscular).

Purpose

The primary goal of this procedure is to remove benign or malignant tumors from the soft tissues of the face or scalp to prevent further growth, alleviate symptoms, or confirm a diagnosis.

Indications

• Presence of a palpable or visible tumor in the soft tissue beneath the fascia in the face or scalp.
• Symptoms such as pain, discomfort, or functional impairments due to the tumor.
• Suspicion or confirmation of malignancy.

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Adjustment or temporary cessation of certain medications, such as blood thinners, based on healthcare provider directives.
• Pre-operative diagnostic imaging (e.g., MRI, CT scan) to ascertain the exact location and size of the tumor.
• Blood tests and other routine assessments to evaluate overall health and readiness for surgery.

Procedure Description

1. Anesthesia: Local anesthesia with sedation or general anesthesia is administered to ensure patient comfort.
2. Incision: A precise incision is made over the tumor's location to expose the underlying tissues.
3. Exposure: The surgeon carefully dissects through the superficial layers to reach the subfascial plane.
4. Excision: The tumor is identified and excised with a margin of healthy tissue. Hemostasis (control of bleeding) is maintained throughout the procedure.
5. Closure: The incision is closed with sutures or surgical staples, and a sterile dressing is applied.

Duration

The procedure typically takes between 30 minutes to 1 hour, depending on the tumor's size and location.

Setting

This procedure is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Surgeon: Performs the excision.
• Nursing Staff: Assists the surgeon and cares for the patient before, during, and after the procedure.
• Anesthesiologist: Manages anesthesia and monitors the patient’s vital signs.

Risks and Complications

• Infection at the surgical site.
• Bleeding and hematoma formation.
• Scarring and potential cosmetic concerns.
• Nerve damage leading to weakness or numbness.
• Recurrence of the tumor.

Benefits

• Removal of the tumor reduces symptoms and prevents further growth.
• Pathological examination confirms the nature of the tumor.
• Improved cosmetic and functional outcomes.

Recovery

• Patients may experience mild discomfort, swelling, and bruising, typically managed with prescribed pain medication.
• Keep the surgical site clean and dry, following care instructions.
• Avoid strenuous activities for a few weeks.
• Follow-up appointment to monitor healing and discuss pathology results.

Alternatives

• Observation: In cases where the tumor is benign and asymptomatic, monitoring may be an option.
• Radiation or Chemotherapy: For certain malignant tumors, these treatments may be used as alternatives or adjuncts.
• Less invasive procedures: Needle biopsy or minimally invasive techniques in select cases.

Patient Experience

Patients may feel some pressure or discomfort during the procedure if local anesthesia is used. Postoperatively, there may be pain and swelling managed with medications. Full recovery typically occurs in a few weeks, with follow-up visits ensuring proper healing and discussing further treatment based on pathology results.