Lipoma Surgery

What is a Lipoma?

A lipoma is a non benign soft tissue lump.

Lipomas can occur anywhere the body stores a layer of fatty tissue. Most are found beneath the skin and in front of the underlying layer of muscle, occasionally they can occur between and within muscles.

It’s very rare for a lipoma to be cancerous. When they are cancerous, we call them sarcomas.

Most lipomas are not painful, however, some lipomas can feel tender like a bruise, but it depends entirely on the mix of cells that are within the lipoma. Those that feel tender are called angiolipomas.

The type of lipoma can only be distinguished by looking at the cells under a microscope and not with imaging techniques. Angiolipomas tend to occur as part of an inherited or genetic syndrome, usually on the limbs.

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How is a Lipoma Removed?

Smaller lipomas are removed under local anaesthetic as a routine procedure. Larger lipomas require a general anaesthetic, but can also be done as a day case. Everyone will experience bruising and will have a scar after the operation.
Risks are low and complications are uncommon. However, like with any operation, there are always some risks such as recurrence or infection. It is uncommon, but occasionally fluid can fill the space where the lipoma was removed, forming a lump called a seroma. The bigger the space after removing the lipoma the more likely you are to develop a seroma.
As the wound heals up, the risk of developing a seroma decreases and any fluid collected is reabsorbed. Seromas can be troublesome when they occur. It is tempting to drain them, but if repeatedly drained, can lead to infection or a cyst wall developing that then needs removing later.

As we’ve seen, most lipomas are benign and removed solely for aesthetic reasons. However, if you have a lipoma that is quite large and causing you some discomfort, it’s better to have it looked at by a specialist

Advice from Consultant Surgeon Mr Kirkby-Bott

When would a Lipoma need to be Removed?

Some lipomas can become quite large and if they are more than 5cm in size or have other suspicious features, they should be evaluated to ensure they are benign.

This is done with an ultrasound scan initially and sometimes with an MRI. If reports come back with suspicious findings, then a core biopsy is performed under local anaesthetic. After the biopsy, a diagnosis will be made, but most doctors will remove a lipoma that is quite large to prevent them from growing any bigger.

Most lipomas are removed for cosmetic reasons or because they cause slight discomfort, so in most cases, they do not qualify for NHS funding to be removed and have to be removed privately.

Angiolipomas that cause discomfort can be removed, but if you are a patient with Dercum's disease, it’s best to have tender lumps removed in batches every 18-24 months. Removing more than six lipomas in any one go is not advised, as this can cause a lot of post-operative pain.

Mr Bott was very professional and discussed my appointment in a very open manner that made me feel relaxed

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