Overview

Although the name "lipoma" may not be recognizable to you, these fatty, rubbery growths are extremely prevalent. In fact, 1 in 1000 persons are thought to have one on their body. Although they can appear at birth or develop at any age, they are most prevalent in adults between the ages of 40 and 60. Lipomas often don't need to be treated. However, soft tissue surgery or excision of the lipoma is the best option if you have one that hurts or is uncomfortable.

What is a Lipoma?

A lipoma is an accumulation of fatty tissue under the skin. Although normally soft, a lipoma can also be solid and squishy. Pushing a lipoma in one way or the other may cause it to migrate somewhat. In healthy, normal individuals, lipomas can appear for no apparent cause. Some persons are predisposed to developing lipomas and may have many lipomas. Lipomas can occasionally run in families.

The majority of the time, people are unaware they have a lipoma until it is large enough to be felt or visible. These soft tissue tumors frequently cause many affected persons aesthetic annoyances. Fortunately, they may be successfully cured with a modest surgical operation that only requires a little skin incision. The lipoma will be submitted for histological study once it has been removed in order to ensure that it is benign in nature.

Are lipomas cancerous?

A lipoma is a mass that develops when there is an excess of fat cells. Lipomas are not malignant and are benign. To be certain that just a lipoma has been removed, your doctor will need to do a histological study on any tissue that is taken. This is due to the fact that occasionally, other under-the-skin lumps and bumps that might be malignant can mimic a lipoma.

What are causes of lipomas?

Lipomas are caused by an excessive localized growth of fat cells. A lipoma's interior is made up of fat cells organized in an expanded pattern and encased in a fibrous capsule. Lipomas often appear when our bodies grow more blemishes, lumps, and bumps throughout time.

While some lipomas will go away on their own, many will not. Some types of lipomas are thought to have a genetic basis for development.

Do I require any investigations or tests before removal?

Before undergoing surgical excision, a lipoma is typically detectable clinically. However, if the tumor is really large or deep, your doctor could advise doing an MRI or ultrasound exam. This makes it possible to determine further details about the lump, such as how deep the lipoma is.

Types of Lipomas

There are several different types:

• Conventional lipomas are the most common type and are made up of white fat cells, which are the type that store energy.
• Fibrolipomas contain fat and fibrous tissue.
• Hibernoma lipomas are made up of brown fat cells, which are responsible for producing heat and helping regulate body temperature.
• Spindle cell lipomas contain fat cells that are more long than wide.
• Pleomorphic lipomas are made of fat cells that vary in shape and size.
• Myelolipomas are composed of fat cells and tissue that is capable of producing blood cells.
• Angiolipomas contain fat and blood vessels, a combination that often causes pain.

When Should a Lipoma be Removed?

Most lipomas are benign and may be ignored. The decision to have a lipoma removed might be motivated by a variety of factors. Following are some typical justifications for choosing to have a lipoma removed:

• You do not like how the lipoma looks.
• The lipoma has grown and has become very obvious and prominent
• The lipoma is causing discomfort and tenderness
• The lipoma is an awkward or sensitive area
• The lipoma is growing
• Your doctor advises you to have a lipoma removed as it is not certain clinically that you have a lipoma and therefore the lump needs removing so it can be analyzed

What are the Pros and Cons of Lipoma Removal surgery?

Pros:

• Surgically removing a lipoma prevents it from becoming larger.
• A biopsy can be performed on the excised tissue to ensure that nothing more dangerous is present. Proactively eliminating it might save your life since deep-seated lipomas can occasionally be mistaken for liposarcomas, which are dangerous tumors.
• You'll probably feel more at ease and pleased with your appearance after the growth is gone.

Cons:

• There’s a small risk of infection or irritation at the removal site.
• The procedure will result in a small scar, so consider the location if that’s a concern.
• There is a chance of lipoma recurrence in the same site or surrounding tissue.

How do I Prepare for a Lipoma Removal?

You will discuss the best way to be ready for surgery with your healthcare practitioner. You could receive a 6-hour no-food-or-drink warning from him or her before your procedure. On the day of your operation, he or she will advise you on which medications to take or not take. A few days before to surgery, you may need to cease taking NSAIDs or blood thinners. Make arrangements for a ride after surgery.

Before your Surgery

The initial step in treating a lipoma is to identify the growth, which is often done through a physical examination. When pressure is applied, lipomas, which are smooth, soft, and doughy, will move about freely. While the majority are tiny and harmless, the lumps can get fairly large if they are not treated. Although they can occur almost anywhere, they frequently arise on the upper body. A single lipoma might exist or many may grow over time.

If you want to have your lipoma removed, surgical excision is typically the best option. The technique, which will differ depending on the size and location of your lump as well as whether you are having a single lipoma removed or several lumps at once, will be thoroughly explained to you by the doctor.

Same-day lipoma removal

It is occasionally feasible to have a consultation and lipoma operation on the same day. If you provide us a picture and have already seen a doctor, such a general practitioner, who has made a clinical lipoma diagnosis, we can schedule this. Only situations when it is regarded safe and suitable to do so are same-day procedures carried out. If for any reason a same-day treatment cannot be performed, the appointment is regarded as a consultation, and future plans might be made for you to undergo surgery.

What will Happen During a Lipoma Removal?

Most frequently, a local anesthetic is used to remove lipomas during an outpatient operation. Depending on the size and intricacy of the lipoma, the surgery lasts between 30 and 90 minutes. For the best comfort, your surgeon could in some circumstances advise removal under general anesthesia. In each case, the lipoma is meticulously injected with local anesthetic to completely numb it before precision surgical excision.

There are two recognized methods of lipoma removal and our surgeons are trained in both techniques:

• Surgical excision
• Liposuction

As it results in complete removal of the lipoma and allows the surgeon to see the lump clearly while performing the lipoma removal procedure, the open surgical excision method is the most popular method used to remove lipomas. After making an elliptical incision in the skin surrounding the lipoma, the lipoma is then gently squeezed out of the incision. The lipoma is then surgically removed and sutured shut. A histology examination of the removed specimen is always conducted in order to rule out any cancerous changes.

Microcannula liposuction is a less invasive technique for removing lipomas that leaves less scarring than the more common open technique. In contrast to the open technique, there is a somewhat increased chance of recurrence.

What to expect after lipoma removal?

Most patients who have a lipoma surgically removed are able to return home the same day. If you have a really large lipoma or multiple lipomas removed, you might need to stay in the hospital for a longer period of time. To reduce the risk of infection, your care team will discuss how to keep the surgical site clean. A lipoma rarely grows back after being removed.

Nonexcisional Techniques

Nonexcisional treatment of lipomas, which is now common, includes steroid injections and liposuction.

Steroid injections cause localized fat to atrophy, which reduces (or, rarely, completely eradicates) the lipoma. Lipomas with a diameter of under an inch are the ones that respond best to injections. The lesion is injected with a 10 mg/mL dose of triamcinolone acetonide (Kenalog) and 1 percent lidocaine (Xylocaine); this operation may be repeated multiple times over the course of a month.

The amount of steroid injected depends on the size of the lipoma and ranges from 1 to 3 mL on average. The number of injections will vary depending on the reaction, which should materialize in three to four weeks. The least total amount of medicine may be injected, and the needle should be positioned such that it is in the center of the lipoma, to minimize complications, which are uncommon but are caused by the drug or the surgery.

Small or big lipomatous growths can be removed using liposuction, especially those that are located in areas where extensive scars should be avoided. It is challenging to completely remove the growth with liposuction. Big-syringe office operations with a 16-gauge needle may be less dangerous than liposuction with a large cannula. For office liposuction, diluted lidocaine often offers sufficient anaesthetic.

Potential Risks and Complications of Lipoma Removal

Before having a lipoma removed, it's crucial to be aware of the dangers and potential side effects. You can be sure that you will get the best care possible before, during, and after your procedure if you choose the Centre for Surgery.

Potential complications of lipoma removal:

• Excessive bleeding
• Fluid or blood accumulation under the skin
• Surgical site infection
• Cellulitis
• Deformity (in the case of large lipomas)
• Muscle irritation

Your surgeon will be able to advise steps you can follow to ensure you avoid any negative side effects.

The Differences Between Lipomas and Cysts

Sebaceous cysts and lipomas are two fairly frequent skin "lumps and bumps" that may both be surgically removed. A sebaceous cyst is a fluid-filled sac beneath the skin that has the appearance of a lipoma and is filled with cloudy fluid. Another routine procedure at the Centre for Surgery is cyst removal. However, there are a few significant distinctions that help to set the two apart:

• Lipomas are located deeper beneath the skin, whereas cysts are more superficial and often tethered to the skin
• Lipomas are soft to tough with a doughy-like consistency. Cysts are firm and sometimes hard to the touch.
• Sebaceous cysts can become inflamed and infected with a punctum (opening) overlying the cyst. Lipomas do not get infected and therefore do not have redness or swelling of the skin overlying the lipoma.

If you see any lumps or swellings on your skin's surface, you should see your doctor. Your doctor can examine you and decide whether or not the lump is a lipoma. Your doctor may advise an ultrasound or a biopsy to further examine the bump.

Lipomas and sebaceous cysts can be easily distinguished with a diagnostic ultrasound scan. An ultrasound scan is necessary to rule out any suspicious characteristics in lipomas that are bigger than 5 cm, actively developing, or uncomfortable. This can be done through your general practitioner, or alternatively, a surgeon at the Centre for Surgery can privately order an ultrasound scan.

Conclusion 

Lipomas can form practically everywhere on the body, however, they are most frequently found on the chest, neck, upper thighs, upper arms, and armpits. There could be one or multiple lipomas present at once. Depending on the size, quantity, and removal technique of the lipomas, lipoma removal surgery is frequently just required to be conducted under local anesthetic and can be completed as an outpatient treatment.