Lipoma Removal

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Lipoma removal

Lipomas are non-cancerous fatty lumps that form under the skin, and often feel soft and mobile. Although they are harmless, they can be unsightly and uncomfortable. Thankfully, they can be effectively excised via a simple removal procedure.

Lipomas are non-cancerous fatty lumps that form under the skin, and often feel soft and mobile. Although they are harmless, they can be unsightly and uncomfortable. Thankfully, they can be effectively excised via a simple removal procedure.

What is a Lipoma?

Lipomas are benign growths of fatty tissues, encased in a membrane of fibrous tissue [1]. Lipomas are often found in the subcutaneous tissue, but may also be found elsewhere such as in the internal organs [2]. Common areas where lipomas are found include:

  • Arms or legs
  • Back
  • Neck 
  • Shoulders
  • Chest
  • Upper thighs
  • Buttocks 

Normal lipomas typically only contain fat tissues. A common subtype is an Angiolipoma which contains a greater density of blood vessels and fat tissue [1].

Although lipomas are common benign growths, not much is known about the exact cause of formation. Other than a few rare genetic diseases, there are no known dietary or lifestyle factors associated with the development of lipomas. common risk factors associated with lipoma growth include [2]:

  • Madelung’s disease — This rare disorder of fat metabolism causes multiple lipomas, especially in men, around the neck, shoulders, and upper body.
  • Dercum’s Disease – A rare condition causing multiple painful lipomas, often linked to metabolic or neurological dysfunction.

Lipomas are harmless and do not necessarily require treatment or removal. Removal is only indicated if the growth gets too big and causes pain or nerve compression, or is cosmetically bothersome. Large growths also have a slightly higher chance of harbouring malignancy.

Lipoma removal in Singapore.
Lipoma removal is a quick, minimally invasive procedure that eliminates unwanted fatty lumps with minimal downtime. 

Should I be worried about a Lipoma?

Most lipomas are benign and not a cause for concern. However, they warrant medical attention if you experience the following:

  • The fatty lump rapidly grows or changes shape.
  • The tissue is painful, tender or inflamed.
  • It is deep-seated and pressing on the nerves, causing pain or discomfort.
  • You have multiple lipomas due to conditions like Madelung’s disease or familial multiple lipomatosis. 

Could it be something more serious?

Liposarcomas are rare and can sometimes be mistaken for lipomas. These are cancerous fatty tumours that require medical attention. If you suspect that the tissue is more than a typical lipoma, consult a doctor for proper evaluation.

Not all skin lumps are lipomas. Other benign skin lumps include epidermal/ sebaceous cysts, fibromas, neuromas, or warts, while malignant ones may include soft tissue sarcomas, and squamous or basal cell skin cancers.

How are Lipomas removed?

Lipoma removal can be considered if the growth starts to bother you, either due to size, location, or whether it causes pain. Treatment to remove lipomas are relatively simple and safe procedures.

Most cases of lipoma removal are done by surgical excision. A surgical excision involves making a cut on the skin and removing the lipoma, followed by stitching the excision wound. Excision is also commonly done as it prevents recurrence or regrowth of the lipoma mass. However, surgical excision can risk leaving scars after removal and recovery.

If you decide to surgically remove a lipoma growth, it is recommended to undergo the procedure while the lesion is smaller rather than waiting for it to grow larger, as this can increase the risk of the lipoma affecting other structures such as joints, nerves, or blood vessels, which may result in the surgical procedure becoming more complicated with higher risks. 

What are the risks associated with Lipoma removal procedures?

Just like any other clinical procedure, lipoma removal procedures may also present some risks, common risks associated with lipoma removal include [4]:

Surgical excision

  • Infections – Infections of the excision wound can occur if the wound is not cared for properly. However, such wound infections only occur 3% of the time.
  • Haematoma and Bruising – Haematomas are formed from the pooling of clotted blood in spaces in the body, this can be caused by damage to blood vessels during surgery.
  • Seroma – Seromas are accumulations of cellular fluids that occur in the empty space/void left behind after the lipoma removal
  • Scarring left by excision wound – Excision wounds from the procedure may result in scars after healing.

What can I expect during a lipoma removal procedure?

Before going for a lipoma removal procedure, you will need a consultation session for your doctor to assess your lipoma growth. Your lipoma removal will typically go as follows:

Consultation

A consultation session is important for your doctor to evaluate your condition and plan the suitable procedure to be performed.

  • Physical examination – Your doctor will examine the lipoma to be removed, as well as check the surrounding area. You may be asked about your medical history.
  • Imaging tests – Imaging tests such as x-ray radiographs, magnetic resonance imaging (MRI), or computed tomography (CT) scans allow the doctor to assess the composition of the lipoma, and whether it has invaded other structures such as the blood vessels or nerves.

Surgery

Before your surgery, your doctor may inform you to stop taking certain medications or to fast from the night before.

  • Preparation – To prepare for the surgery, you will be put under local or general anaesthesia. With local anaesthesia, you will be awake and conscious during the procedure, while under general anaesthesia, you will be asleep or unconscious. The surgeon will clean the area with antibacterial soap and shave it as well.
  • Removal procedure – Your doctor or surgeon will then perform the removal as planned. An excision wound is made to extract the lipoma, after removal the skin is stitched to close the wound. If the lipoma is large enough, excess skin is removed before suturing the wound.
  • Biopsy – All specimens removed will be sent to the lab for histological assessment. This will allow a definitive answer as to the nature of the tissue. 

Recovery

Typically, lipoma removals are done on an outpatient basis. You should be able to go home after your surgery. Before discharge, your doctor may give care instructions to take care of your surgical wound.

  • Cleaning – Keep the wound clean and dry to ensure proper healing. You may need to change the dressing if it gets wet.
  • Pain management – Your doctor may prescribe you some pain medication such as ibuprofen or acetaminophen to alleviate pain and inflammation.
  • Follow-up – Your doctor may request you to come in for a follow-up appointment to ensure proper healing, as well as to check for regrowth or recurrence.

Summary 

Lipomas generally do not require any treatment when small and asymptomatic. A lipoma removal may be recommended if the growth causes pain or discomfort. Lipoma removal is a straightforward and effective procedure, usually performed under local anaesthesia with minimal downtime. These minimally invasive procedures generally entail a quick recovery with minimal scarring. 

If you, however, experience a rapidly growing lump with pain or discomfort, it is important to consult a doctor. Schedule a consultation with us today for a thorough assessment and personalised treatment plan. 

Frequently Asked Questions

What happens if lipomas are left untreated?

Lipomas left untreated will either stay the same or slowly grow larger. If it does not concern you or cause any discomfort, leaving the growth untreated typically will not cause any problems.

Can lipomas grow back?

Lipomas may grow back, the risk of recurrence also increases with incomplete removal of the lipid mass.

Are lipomas cancerous?

Lipomas are not cancerous, and will not turn into malignant growth. However, lipomas may resemble liposarcoma, which is a malignant tumour growth of fat cells. This is why it is recommended to get a proper diagnosis before the removal of the growth.

Is lipoma removal considered major surgery?

No, lipoma removal is generally considered a minor procedure, especially for small and superficial lipomas. The procedure is generally done under local anaesthesia and takes only 15 - 30 minutes. Larger or deeper lipomas, however, may require general anaesthesia. That being said, it is still not considered major surgery unless extensive tissue is removed or reconstruction is required.

References

  1. Kim S, Ha C, Kwon AY, Choi W. Lipoma with osteocartilaginous metaplasia in infrapatellar fat pad: A case report and review of literature. Medicine (Baltimore). 2022 Oct 21;101(42):e31303. doi: 10.1097/MD.0000000000031303. PMID: 36281105; PMCID: PMC9592374.
  2. Kosztyuova T, Shim TN. Rapidly enlarging lipoma. BMJ Case Rep. 2017 Sep 23;2017:bcr2017221272. doi: 10.1136/bcr-2017-221272. PMID: 28942406; PMCID: PMC5747774.
  3. Pinski KS, Roenigk HH Jr. Liposuction of lipomas. Dermatol Clin. 1990 Jul;8(3):483-92. PMID: 2199109.
  4. Chen CY, Fang QQ, Wang XF, Zhang MX, Zhao WY, Shi BH, Wu LH, Zhang LY, Tan WQ. Madelung's Disease: Lipectomy or Liposuction? Biomed Res Int. 2018 Feb 21;2018:3975974. doi: 10.1155/2018/3975974. PMID: 29682541; PMCID: PMC5840946.

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