Lipoma Treatment
Removal or observation of benign fatty lumps when they are painful, growing or bothersome
What is lipoma treatment?
A lipoma is a benign growth of fat cells inside a thin capsule, sitting in the layer between the skin and the muscle. It is the commonest soft tissue growth in adults.
Under the fingers it is soft, doughy and moves freely, because the capsule is attached neither to the skin above it nor the muscle below. It grows very slowly over years and often stops at a certain size and stays there.
Some people develop many of them, and that tendency runs in families. Being overweight does not cause them and losing weight does not remove them, since the fat inside a lipoma behaves independently of the body's ordinary fat stores.
What you might notice
- A soft lump under the skin
- A lump under the skin that has become red and painful
How it is diagnosed
A doctor usually recognises a lipoma by feel. It is soft and mobile, has a definite edge, and the skin over it looks normal and slides freely across it.
An ultrasound is used where the lump is deep, where its edge is indistinct, or to separate a lipoma from a cyst, which can feel similar but sits at a different level in the skin.
An MRI is arranged for a lump that is large, lies below the muscle layer, or has been growing steadily. A rare malignant tumour of fat exists, and size and depth are the features that raise the question. Whatever is removed goes to the laboratory in every case, however typical the examination was.
Recovery
Removal is done under local anaesthetic and you walk out afterwards. The area is numb for the rest of the day and then aches mildly for a few days.
Stitches come out in about a week. The scar is roughly as long as the lump was wide, since the capsule has to come out whole, and it fades over several months.
A cavity is left where the lump was, and it fills with fluid for the first fortnight, so the area can feel as though something is still in there. A firm dressing over the first days limits how much collects.
If it is left untreated
A lipoma that is not growing and not in the way can be left indefinitely. It will not turn into anything else, and leaving it is a perfectly reasonable choice.
The reasons people have one taken out are practical: it catches on a waistband or a strap, it has grown large enough to show under clothes, or it has begun pressing on a nerve and become tender.
The one situation that is not for watching is a lump that has started growing faster than it used to, has become fixed to what is around it, or sits below the muscle layer. Those need imaging before any decision to leave them alone.
Questions about lipoma treatment
Can a lipoma be removed without cutting?
Not completely. Liposuction can empty a large soft one through a very small incision and leaves a shorter scar, but it leaves the capsule behind and a proportion refill over the following years. It also gives the laboratory nothing solid to report on. Where the diagnosis matters or the lump is firm, taking it out whole is what is done.
Do lipomas turn into cancer?
A true lipoma does not. There is a separate malignant tumour of fat cells, called a liposarcoma, and it is rare, but a small one can resemble a lipoma from the outside. Lying below the muscle layer, a size above five centimetres and steady growth are the features that prompt a scan first. Everything removed is sent for a report regardless.
Will it come back?
Not in the same place, provided the capsule came out whole. Recurrence at the site is uncommon. What does happen in people who tend to form them is that new ones appear elsewhere over the years, and that pattern has nothing to do with how the first one was treated.
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Day CareTalk to a care coordinator about lipoma treatment
Leave a number and a care coordinator calls you back with what the treatment involves and which hospital it would be at. They book a consult only if you want one