What is a Lipoma?

A Lipoma is a benign and non-cancerous growth located in the subcutaneous/fatty tissue layer of the skin. The lump is formed by mature fat cells (adipocytes) and is enveloped/encapsulated by a fibrous tissue capsule. 

Due to the location of the lipoma in the subcutaneous layer, it can often be moved around under the skin and has been referred to as a ‘skin mouse’. The skin overlying the lipoma is often normal. 

Lipomas can occur on any part of the body that contains subcutaneous tissue. However, it is commoner on the torso, posterior neck, and the upper extremities. It is very uncommon to develop on the scalp, and a scalp lump is usually a trichilemmal cyst rather than a lipoma. 

A variant of the lipoma is an Angiolipoma. 

Alpine Surgical Practice is committed to practicing safe and reliable surgery to treat all lipoma issues.

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Should I remove my Lipoma?

A lipoma should be removed if it is causing pain or inconvenience to daily life. Examples of inconveniences include the lipoma catching on clothing or jewellery or if it is on a part of the body that easily gets impacted or knocked on. 

In addition, it is up to the individual if he/she wants to have the lipoma removed, regardless of whether the lipoma is symptomatic. 

Will my lipoma turn cancerous in the future?

The cancerous counterpart of a lipoma is termed a Liposarcoma. It is the majority opinion of the scientific community that benign lipomas do not transform into cancerous liposarcomas. A Liposarcoma arises from the get-go as a cancerous element rather than coming through the route of transforming from a benign lipoma to a cancerous liposarcoma. The long and short of it is that a benign lipoma is very unlikely to turn cancerous. 

However, the difficulty is determining whether a lump of lipoma is benign or cancerous and therefore warrants removal for further assessment. Some symptoms and signs pointing to a more worrying cause include: 

  • Painful lipomas 
  • Lipomas enlarging at a fast pace
  • Lipomas with overlying changes to the skin 
  • Non-mobile lipomas that feel fixed in location 
  • Lipomas located on the buttocks, thigh, and groin

Generally, if there is any doubt or if the individual wishes to have a peace of mind, an excision of the lipoma is warranted. 

How is the surgery for the lipoma carried out?

The surgery can be carried out under local anaesthesia or general anaesthesia. The choice of anaesthesia depends on the size and location of the lipoma. 

For procedures carried out under local anaesthesia, an injection of the local anaesthetic drug will be performed around the lipoma under sterile conditions. The local anaesthesia will take about 3-5min to achieve its full effect and will allow the surgery to be carried out with minimal pain. An incision on the skin will then be made over the lipoma and the lipoma will be freed from the surrounding tissues and extracted from the incision. The incision is usually smaller than the size of the lipoma yet allows the safe extraction of the lipoma. Lipomas on the upper extremities and torso (with the exclusion of the posterior neck region) are usually smaller in size and located relatively superficially and can hence be removed under local anaesthesia. 

Larger and deep-seated lipomas are removed under general anaesthesia and these are usually in the posterior neck, buttock, groin, and upper thigh regions. The operative procedure is otherwise similar to that carried out under local anaesthesia. 

The incisions will usually be stitched up with buried absorbable sutures and hence avoiding the need for a repeat visit for removal of the stitches. The incisions will usually unite and heal in about 2 weeks. 

What are the risks of the surgery?

Lipoma removal surgery is a very safe surgery. The main risks pertain to wound infection, bruising, seroma formation (accumulation of fluid in the ex-lipoma site) and scarring. Wound infection risk should vary 1-3% with the majority treated with antibiotics. Seroma formation is usually of no major consequence as the fluid is reabsorbed back into the body over a period of 1-2 weeks. Scar formation can be reduced, particularly over scar-prone areas with a combination of anti-scarring cream and anti-scarring dressings. 

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