Question explored with the scientific record
Conversation so far
- 1 Can you safely remove 100% gold needles that look like susuk needles from your forehead without major surgery? In the subcutanous somewhere. In order to have ultherapy and fotona 5d. The Ct angiogram says they are beneath the scalp but haven't consulted radiology yet on it. + a private exchange
- 2 But if the ultherapy avoids the needles at the forehead (provided they are there) just to do the eyes, is it still possible as long as they are precisely mapped? Same with fotona 5d? + a private exchange
- 3 What kind of nerve damage can happen in the forehead? + a private exchange
- 4 What if it was done via endoscopic brow lift?
- 5 But if the needles are closer to the scalp, could a scalp incision not hide the scare more to remove them with one incision?
Answered on this page ↓
But if the needles are closer to the scalp, could a scalp incision not hide the scare more to remove them with one incision?
The short version: a scalp incision would not hide the scar better than a forehead incision for needles this small, and the evidence does not test the idea.
The retrieved studies are about removing large foreign bodies from deep tissue, not tiny gold needles from the forehead [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15]. One study shows ultrasound can detect foreign bodies as small as 0.5 mm [16], which matters for localization. But none of these records compare scalp versus forehead incisions for needle removal, and none measure cosmetic outcomes for either approach.
The anatomy works against you. A scalp incision near the hairline can reach the forehead only by tunneling under the galea, which means wider dissection, more tissue disruption, and a longer recovery. The needles are small and shallow. A direct incision over each needle, placed in a forehead crease, heals with a scar that is usually invisible within months. The scalp approach trades a visible scar for a hidden scar plus a bigger surgery. That is a reasonable trade only if the needles are deep enough that a direct incision would damage a nerve or vessel. Imaging before surgery would settle that.
The evidence here does not support the scalp approach as better. It supports the opposite: more dissection for a problem that direct access can solve. The burden of proof is on the heavier intervention, and nothing here meets it.
My call: choose direct small incisions with imaging, not a scalp tunnel, unless imaging shows a needle tucked where direct access would endanger a nerve. Confidence: low, because no study in this retrieval compares the two approaches for needle removal.
Sources used 16
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Intramyocardial foreign body
This study reports a rare case of constrictive pericarditis caused by an intracardiac sewing needle in a 72-year-old woman, highlighting the surgical approach for removal and the implications of such foreign body injuries.
DOI: 10.1007/s11748-005-0145-0 -
Surgical Removal of an Intramedullary Spinal Cord Foreign Body Granuloma in a Dog
This case report details the successful surgical removal of an intramedullary spinal cord foreign body granuloma in a dog, which led to significant neurological recovery post-operation.
DOI: 10.5326/0390306 -
What Is Your Diagnosis?
A dog sustained thoracoabdominal impalement from a wooden foreign body, diagnosed radiographically and intraoperatively, surgically removed with diaphragmatic involvement, treated with thoracic lavage and antibiotics, and recovered uneventfully.
DOI: 10.2460/javma.242.11.1487 -
Suprascleral removal of a foreign body from the retrobulbar muscle cone in two dogs
This study presents a novel suprascleral surgical approach for the removal of a foreign body from the retrobulbar muscle cone in two dogs, demonstrating its effectiveness and discussing the associated advantages and disadvantages.
DOI: 10.1111/j.1748-5827.2003.tb00098.x -
Vast collection of foreign bodies in the stomach presenting as acute gastrointestinal bleeding in a patient with schizophrenia
This case study details a 24-year-old patient with paranoid schizophrenia who presented with upper gastrointestinal bleeding due to the ingestion of over 50 metallic foreign bodies, which were successfully removed through surgical intervention.
DOI: 10.1055/s-0034-1392611 -
Liver inflammatory pseudotumor due to an intrahepatic wooden toothpick
This study presents a case of a 63-year-old man who developed a liver inflammatory pseudotumor due to the intrahepatic migration of a wooden toothpick, leading to cholangitis and ultimately requiring surgical intervention to remove the foreign body.
DOI: 10.1016/j.jhep.2004.02.035 -
Ingested Foreign Bodies of the Gastrointestinal Tract: Retrospective Analysis of 542 Cases
This study presents a retrospective analysis of 542 cases of ingested foreign bodies in the gastrointestinal tract, highlighting the management strategies, outcomes, and the demographics of affected patients over a 20-year period.
DOI: 10.1007/s002689900152 -
A foreign body in the mediastinum as a cause of chronic cough in a 10-year-old child with asthma
A 10-year-old boy with asthma presented with a five-month chronic cough; imaging revealed a mediastinal 3 cm metallic wire from a foreign body aspiration, which was surgically removed, resolving the cough and illustrating that chronic cough in pediatric asthma may arise from a f…
DOI: 10.1080/02770903.2019.1684515 -
Echocardiographic detection of intracardiac non-metallic foreign body complicated by infective endocarditis
This case study describes the successful surgical removal of a bamboo stick from the left atrium of an 11-year-old boy, which was complicated by infective endocarditis, highlighting the importance of echocardiographic detection in such rare cases.
DOI: 10.1093/eurheartj/ehl168 -
Sonographic detection of indian grass ( Sorghastrum nutans ), an unusual foreign body, in the urinary bladder
This study reports a case of an adult male who had Indian grass inserted into his urinary bladder, which was successfully detected via sonography and removed surgically, highlighting the unusual nature of such foreign bodies and their implications for diagnosis and treatment.
DOI: 10.1002/jcu.20293 -
Mass and Shape as Factors in Intraocular Foreign Body Injuries
This study investigates the relationship between the mass and shape of intraocular foreign bodies (IOFBs) and the resulting visual outcomes and complications in 69 patients, revealing that greater mass is associated with worse outcomes and that blade-shaped IOFBs penetrate the e…
DOI: 10.1016/j.ophtha.2006.06.002 -
Self‐Embedding Behavior in Adults: A Report of Two Cases and a Systematic Review
Adult self-embedding behavior involves recurrent insertion of foreign objects into soft tissues, with a systematic review of 32 cases plus two illustrative cases showing needles predominate, diverse psychiatric comorbidity (psychosis, borderline personality, and factitious disor…
DOI: 10.1111/1556-4029.13359 -
Perfluorocarbon liquid-assisted intraocular foreign body removal
This study presents two cases demonstrating the effectiveness of perfluoro-N-octane (PFO) as a surgical adjunct in the removal of nonmagnetic intraocular foreign bodies (IOFBs) from the macula and posterior segment, highlighting its protective role for the retina during the proc…
DOI: 10.2147/OPTH.S159509 -
Obstructive ileus caused by a swallowed foreign body (a “press-through” package) and preexisting adhesions
This study reports a rare case of obstructive ileus in a 54-year-old man caused by a swallowed 'press-through' package (PTP) that became lodged in the cecum due to preexisting intestinal adhesions.
DOI: 10.1016/s0735-6757(97)90048-6 -
Traumatic calvarial stone: A rare case report and review of the literature
This study presents a rare case of traumatic calvarial stone injury resulting from a road traffic accident, highlighting the importance of early surgical intervention and the potential complications associated with penetrating head injuries.
DOI: 10.4103/0028-3886.91397 -
Musculoskeletal Ultrasound and MRI: Which Do I Choose?
This review argues that musculoskeletal ultrasound should be viewed as a complementary imaging modality to MRI, with clear advantages in foreign body detection, peripheral nerves, dynamic imaging, and soft tissues adjacent to hardware, while acknowledging scenarios where both me…
DOI: 10.1055/s-2005-872339