Over a lifetime, it is normal to accumulate a small collection of minor annoyances with our bodies. A poorly placed freckle, a tiny chip in the tooth, or a creaky wrist are symptoms of the human condition that many will simply ignore.
When it comes to their bodies, people have been hardwired to worry about unnatural lumps. Lipomas are among the most common lumps on the human body, and while they might be responsible for the short term worries of some, they often become just another benign part of life for many.
But it doesn’t have to be that way. Here we discuss the intricacies — and effectiveness — of various lipoma removal options.
What is a lipoma?
“A lipoma can be very small, one to two centimeters [roughly half of an inch], but can also grow to a tremendous size, like an orange, or even bigger,” says Dr. Barbara Bergin, an orthopedic surgeon in Austin. “It’s soft and creamy yellow, like white corn, and usually a single glob of fat, perhaps looking like an egg yolk. But in some cases, it can be lobulated — having the shape of one of those turtle candies.”
The lumps are benign tumors consisting largely of fat cells and, in some cases, blood vessels. A key sign to keep in mind when determining if a growth is a lipoma or a more serious lump is whether the lump is movable or feels stuck in place. Lipomas should move, within reason.
There are no known reasons why lipomas form, yet certain factors appear to contribute to their occurrence. Genetics influence the formation of these “fatty tumors,” as children born to parents with the growths have a higher chance of developing one or multiple lipomas themselves. Lipomas tend to form in people over the age of 30, and minor injuries to soft tissues encourage the formation of the growths.
That being said, lipomas can appear on anyone. The growths occur just below the surface of the skin and are easily visible. Lipomas tend to form on the neck, torso, shoulders, and near armpits, though they can appear essentially anywhere on the body.
When lipomas forms on certain parts of the body, such as near joints, they can cause a level of discomfort, and even impede mobility. “If they get really, really large, or grow quickly over a short period of time, a physician might recommend an MRI to be certain of the exact size and shape of the lipoma, and, more importantly, to make sure there is no indication that this mass could be malignant,” says Bergin.
Lipoma excision, step by step
As lipomas are generally painless and harmless, many people do not opt for their surgical removal. “Most docs recommend that the patient live with it,” says Bergin. “They’re benign. The only reason to remove them is if they hurt, show rapid growth in size, or if they bother something else — like if they rub or pinch against something.”
Practicality aside, as lumps may occur virtually anywhere on the body, they can cause undesirable cosmetic outcomes. In such cases, patients should seek out a qualified plastic surgeon to ensure the complete removal of the fatty tissue.
“The main reason most people have them removed is because they don’t like having a bump, or they don’t like the way they look,” says Bergin. “Having a mass is a perfect rationale for lipoma excision. It’s not a cosmetic procedure like a facelift, and insurance companies always pay for the operation.”
The removal of small and average sized lipomas is performed under local anesthesia, while the patient is awake. Larger lipomas, and lipomas in hard to access areas of the body, require general anesthesia.
“Removing a lipoma is generally an easy process for the patient and the doctor,” says Bergin, “it’s not a very painful operation and is almost always a day surgery procedure.” The removal process takes between 15 minutes to an hour, depending on the size and location of the lump.
“A small incision is made in the skin and the lipoma is simply removed,” remarks Dr. Jennifer T. Haley, a board-certified dermatologist in Scottsdale, Arizona. These incisions can be up to two inches long, and leave very minimal scaring once fully healed.
“Usually, two layers of sutures are performed — one that will be removed in ten to 14 days, and another that will stay in and be absorbed by the body in three to six months,” says Haley. “A pressure bandage is placed over the wound, and heavy activity should be avoided for at least 48 hours to avoid complications.”
After the sutured area heals, the lipoma should not return, and no further steps are needed. “The lipoma may recur, or be incompletely removed with one procedure, less than 5% of the time,” says Haley. Typically, patients who are predisposed to lipomas develop more of them, rather than the specific one recurring.”
The removal process is relatively safe, with the same basic risks as any medical procedure. “There are rarely complications,” says Bergin. “Occasionally a nerve might cross the skin where the incision is made, and there could be numbness in the skin afterwards. A person could also get an infection, but this would be extremely rare.”
Other treatment options
While surgical removal is the most common lipoma treatment, and the procedure that provides the best long term results, other options do exist.
Liposuction to remove a lipoma offers reduced scaring when compared to surgical removal. After localized anesthetic takes hold, a large gauge syringe is used to suction out the lipoma. This procedure does have an increased chance of leading to the lipoma’s regrowth, as entirely removing the lump can be difficult.
Steroid injections can help to shrink smaller lipomas, but since the lump isn’t removed they tend to grow back over time. Certain medical professionals may recommend steroid injection prior to the surgical removal of lipomas in order to shrink the growths, and reduce scaring.
Several topical home remedies for lipomas also claim to offer relief. These range from simple apple cider vinegar to chickweed ointments, though there is little medical evidence to support these solutions.
Home remedies for lipomas claim to offer relief. However, there is little medical evidence to support these solutions.
Less common lipomas
While most lipomas occur directly below the skin, others are less convenient. “There are some lipomas called intramuscular lipomas, which, while still being benign, grow within a muscle,” says Bergin, “this can cause pain, and the problem with these lipomas is that they’re harder to remove completely.”
The removal of an intramuscular lipoma takes longer than its traditional counterpart and, if not removed completely, the lump can regrow. Following the removal procedure, recovery is more complex as well. “In a few cases of intramuscular lipomas, there can be persistent pain, if it was painful in the first place,” says Bergin.
While nearly all lipomas are harmless, an extremely rare form of cancer known as liposarcoma can resemble a lipoma. This form of cancer occurs in fat cells, but accounts for a small minority of lipoma cases. In the 24 years between 1985 and 2009, only 6,370 cases of liposarcoma were reported in England.