Lipomas are tumors that are made up of adipose (fat) tissue and are found under the skin in the neck, shoulders, back, and other areas of the body. These tumors grow slowly and are almost always benign, which means that many lipomas are present without causing any symptoms. Upon physical examination, a lipoma will be soft, round, and movable. They feel doughy and do not cause pain upon palpation. Some conditions can be associated with lipomas including Gardner’s syndrome, adiposis dolorosa, multiple lipomatosis, and Madelung’s disease. There are also several varieties of lipoma including neomorphic, spindle cell, angiolipomas, and adenolipomas. In most cases, lipomas can be left untreated and cause no problems. In more severe cases, treatment may be necessary to prevent complications.
Two major types of nonsurgical treatment are available for lipomas. The first is steroid injections. When steroids are injected into lipoma tissue, they cause death of the fat tissue. This causes the lipoma to shrink or even disappear in rare cases. Xylocaine and Kenalog can be injected into the center of the lipoma once per month or more. Response to this treatment typically takes several weeks, so the number of steroid injections needed will depend on how well the lipoma responds.
Another type of nonsurgical lipoma treatment is liposuction. Because lipomas are composed of fatty tissue, liposuction can be used to remove this tissue and shrink growths. In a medical office, liposuction can be done using diluted lidocaine as an anesthetic and a 16-gauge needle with syringe to complete the process. This is safer than other types of liposuction and can result in faster recovery and fewer complications.
Lipoma Removal by Excision
If lipomas become problematic, lipoma removal can be done using an excision procedure. Before the excision, the lipoma is marked off with a marker on the skin. The skin is then cleaned with Betadine or Betasept to ensure a sterile surgical area. After draping, the procedure begins and will proceed based on the size of the lipoma. Large lipomas can be excised by making incisions in the skin above the lipoma. During this procedure, doctors must be careful to avoid cutting nerves or blood vessels. Some complications of excision can include infection, bruising, blood vessel injury, scarring, and muscle injury. Severe complications can include fat emboli and damage to the nerves surrounding the site of the lipoma.
Salam, G.A., M.D. (2002). “Lipoma Excision.” American Family Physician. Published March 1, 2002.