The little guy in my head

September 17, 2014 7:29 AM

I have a BB in my forehead (my left eyebrow to be precise). I haven't had any issues until recently-- I've been having headaches with pain focused on this area. The BB isn't really noticeable until I raise my eyebrow, but you can definitely feel it. I don't know what kind of BB it is, either.

You are not my doctor, nor my insurance agent. This happened about 10 years ago, when I was hanging out with the bad kids, one of whom was waving a BB gun around. He fired the thing, it ricocheted off a wall and hit me right above the eye. I don't think I realized that the BB was actually still in my head until later but being a middle school kid, I never told my parents and never had it checked out until more recently. Five years ago, I asked my doctor (who is no longer my PCP) about it and she told me that if there hasn't been any pain it should be okay. She also informed me that it would take some plastic surgery to pop it out.

Now that I'm getting these headaches, I wonder if it's time (I know, I know...it was probably time 10 years ago) to get it out and would my (US, Blue Cross/Blue Shield) insurance cover this kind of surgery? If the headaches stop and I leave it, am I at risk for other issues? I would be a little sad to lose my party trick, but I would still have the story at least.

posted by thefang to Health & Fitness (16 answers total)

Since you have insurance, why not make an appointment with your doctor and see what he says? In general, it's a bad idea to have foreign material floating around in your body, but your doctor ought to be able to assess the situation professionally and let you know what your options are.
posted by ubiquity at 7:40 AM on September 17, 2014 [6 favorites]

The bb might have lead, which is not good for you, so even if the headaches stop, you should probably still get it removed. Does your current doctor know about this? What does she or he say about it. A bb is pretty small and if you don't mind having a small scar I don't know why you would need plastic surgery.
posted by mareli at 7:42 AM on September 17, 2014 [5 favorites]

I had a similar experience as a kid, and the doctor removed the offending pellet in his office with a local anesthetic and there is barely a scar at all.

I can't imagine that removing that thing from your eyebrow would be that involved - even if insurance covered nothing at all, it wouldn't expect it to cost too much.

FWIW, my septoplasty was also called a cosmetic (plastic) surgery, even though it was functionally necessary. I think any surgery where they are concerned at all about how the scar will heal and show is considered cosmetic these days. I wouldn't let it dissuade you from talking to your doctor about it and seeing what options you have.
posted by Pogo_Fuzzybutt at 7:46 AM on September 17, 2014 [1 favorite]

I would definitely remove it. You might also want to get tested for lead poisoning. Just call your insurance to ask about coverage.
posted by three_red_balloons at 7:50 AM on September 17, 2014

Most likely not lead. Most BBs are copper. Pellets are often lead, but you would know the difference by touch, and a pellet would have flattened on first impact anyway.

I had something like this in my knee (still do). I crashed on a hill on my skateboard. Tore up my skin on my knee pretty bad. Didn't think much of it, but when the scab healed I felt there was a rock under it. This popped out when I picked the scab. Little did I realize I had others in there and when all was fine and healed and I felt around I could still peel more tiny peoples (size of pees). I got annoyed by them because they would occasionally hurt. So I did my own surgery. A tiny slice with an exact knife and I had a cut about the width of a pee. I then popped the rock out and all was fine, except I couldn't get the second one and there was blood and it got messy and it didn't work out like I expected. I could put the point of the razor in my open wound and feel it tap stone. Eventually I gave up on the second one, and decades later seldom think about it.

I can still reach down there and play with the pebble in my knee.

I realize home surgery isn't the best advice, and I am not encouraging this. I am just saying if I could do it without proper tools a doctor should be able to get it done fairly quickly.

Also, I wouldn't worry about the lead anyway, wouldn't think this is causing your problems, but still think it's not a bad places to start and you should have it out if you think it's bothering you.
posted by cjorgensen at 7:59 AM on September 17, 2014 [2 favorites]

Plastic surgery is not the same as cosmetic surgery.
posted by amtho at 8:10 AM on September 17, 2014 [2 favorites]

Just talk to your doctor about it and maybe get a referral to a dermatologist. Most dermatologists do small in-office procedures like biopsies and the like, and should be able to handle this without a lot of fuss. They just say "plastic surgery" when they are concerned about scar tissue forming - for example, I had a bad cat scratch in my face and had a plastic surgeon sew it up and do follow-up care, but it's not as involved as actual surgery or anything. Plastic surgeons are just more skilled at minimizing scars than other doctors.
posted by bedhead at 8:20 AM on September 17, 2014

A kid I knew in junior high had been in a pellet gun fight with his older brother (this was a thing they did regularly, evidently). He had a pellet in his cheek, about an inch below his eye for roughly five years. When it was finally pulled out, he brought it to school to show everyone, and it was horribly corroded. It was absolutely disgusting, and it had been in his face, slowly breaking down, for roughly as long as yours. You want to get that thing removed.

As a fun little side story, he walked home past a junkyard with an electromagnet everyday from the bus stop. He said he could tell when it was being used, because his pellet would pull towards it. Get it out.
posted by Ghidorah at 8:23 AM on September 17, 2014 [10 favorites]

FYI, my wife had a mole on her nose that turned out to be skin cancer. The surgery to remove it was done at a "cosmetic surgery center." The mole removal was done by a skin cancer surgeon, and was immediately followed by a skin graft done by a plastic surgeon (different doctor) to reduce the appearance of scarring. Our insurance paid for it like they would pay for anything else deemed "medically necessary."

YMMV (I don't have BC/BS), but I would think it would be deemed "medically necessary" to remove the BB to prevent future related headaches, even though it is "cosmetic surgery."
posted by tckma at 8:39 AM on September 17, 2014

If you needed to have an MRI of your head done, you don't want that BB in your face to come ripping out in the middle of the scan. Go have it removed.
posted by royalsong at 8:53 AM on September 17, 2014 [14 favorites]

I would have the bb removed for the same reason I remove my wedding ring before certain types of work. An insignificant piece of metal can be a major factor in the seriousness of an accident.
posted by Lesser Shrew at 9:10 AM on September 17, 2014

Best answer: I had a BB removed from my shoulder after it had been there for years due to my bra strap constantly irritating it. I thought he'd just make a small incision and pop it out, and perhaps my doctor was a butcher about it due to the area, but scar tissue around it caused some trouble. I ended up with a single stitch and what looks like a vaccination scar. That's cause enough for a plastic surgeon to do it.

Your headaches: Do you have an actual headache or do you have a localized pain that feels like the pressure building from a pimple? Because like cjorgensen I have a number of small rocks in my skin. Occasionally one works its way to the surface and when they do, it can be quite painful from fluid buildup around it. Either way, if it's causing you headaches you should see a doctor.

FWIW I have another BB and a pellet in my arm and every doc I've ever asked about them just shrugged about it, basically saying if it's not bothering me to leave it alone.
posted by barchan at 9:29 AM on September 17, 2014 [3 favorites]

BBs are usually copper coated steel, pellets are lead. Either way, probably not a bad idea to have it removed.
posted by Ham Snadwich at 9:47 AM on September 17, 2014

If you needed to have an MRI of your head done, you don't want that BB in your face to come ripping out in the middle of the scan. Go have it removed.

Worth noting is that even if it doesn't get ripped out - because it is non-ferrous - it will likely heat up like a pot on an induction range.

Which I think would be less pleasant than removal, actually.
posted by Pogo_Fuzzybutt at 11:54 AM on September 17, 2014

Like said above, if during the rest of your life you ever have symptoms of a stroke it's gonna be a real bummer if they can't do an MRI head in the ED because of something like this.


Get it out while the getting's good.
posted by sanderman at 4:53 PM on September 17, 2014

Hey, I wouldn't worry too much about the MRI safety aspect of it, anything shorter than a centimetre won't cause noticeable inductive heating (I think 3cm is the safe limit as a rule of thumb), and something that small won't have a sufficient force exerted on it to rip it out of your skin* (I've walked around an MRI scanner with a big metal belt buckle, and you can feel a slight tug, but you don't go flying off your feet or anything). The only issue if you had a scan is that it would probably compromise image quality in the immediate area of the BB, but nothing too serious (also true for CT scans).

Saying that though, it sounds like you might as well get it removed, if you think it's giving you headaches and you've got insurance why not?



*though you should always disclose any information about things like this to the MRI staff, as they'll know best.
posted by Ned G at 3:49 AM on September 18, 2014