Dermoid Gallery Patient 240374

Before Surgery

Bella's family noticed a small bump near the outer part of her left eyebrow since shortly after she was born infancy. As she grew, the lesion became more noticeable and created fullness along the left brow.

On examination, the mass was most consistent with an anterior orbital dermoid cyst, the most common benign orbital tumors seen in children. Dermoid cysts are developmental lesions that form before birth when a small amount of skin tissue becomes trapped beneath the surface during normal development.

Although harmless, these cysts do not disappear on their own. Instead, they usually enlarge slowly and may become increasingly visible. In some cases, trauma causes a dermoid cyst to rupture, leading to inflammation with irregular scarring under the skin, making future surgery more difficult.

Surgery

After discussing the options with Bella's family, they elected to proceed with surgical excision. The dermoid cyst was removed through a carefully placed incision hidden within the natural crease of her upper eyelid.

When possible to use this approach, it provides excellent access to the cyst while allowing the eventual scar to blend into the eyelid's normal skin crease. The cyst was removed completely, and the surgery completed without complication.

After Surgery

The photograph on the right was taken several years after surgery.

The normal contour of Bella's brow has been restored and the surgical incision is extremely difficult to detect.  There is little visible evidence that surgery was ever performed.

Like many young children who undergo dermoid removal, Bella has no memory of the procedure itself.

What Parents Should Know

Orbital dermoid cysts are common, benign growths that are present from birth. They most often appear as a firm, painless lump near the outer portion of the eyebrow.

While these cysts are not dangerous, they generally continue to enlarge gradually and do not resolve without treatment. For many families, surgery is chosen to remove the lesion before it becomes more noticeable or before inflammation from rupture can occur.

The Goal of Treatment

The goal is complete removal of the cyst while preserving a natural appearance.

When surgery is performed through a hidden eyelid-crease incision, the scar often becomes very difficult to see. Bella's result demonstrates what many families hope for: a normal brow contour and little evidence that the dermoid was ever there.