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What is Excision of Lipomas?

The surgical removal of lipomas is referred to as excision of lipomas.

A lipoma is an abnormal growth of fat cells (tumor) that develops just under the skin. Lipomas can occur anywhere in the body but are most commonly found on the shoulders, neck, chest, arms, and back. Lipomas are generally small in size (about 1-3 cm) that grow very slowly and generally do not cause pain or any other symptoms. But if developed deep inside the body, a lipoma can press against an organ or nerve, causing related symptoms.

A lipoma can be easily diagnosed by its appearance and the feel of it when palpated. It is typically a smooth, soft, rubbery lump that may readily move about with slight finger pressure. But, sometimes an ultrasound scan, MRI or CT, and biopsy (sample of tissue is taken for lab examination) may be performed to rule out liposarcoma (cancer of fat tissue).

Indications for Excision of Lipomas

Lipomas are noncancerous and therefore do not require treatment; however, they may be surgically removed if symptoms develop. These include pain, tenderness, enlargement, or foul-smelling discharge from the lipoma, presence of swelling, and infection or functional impairment caused by deep-lying lipomas. Additionally, concerns related to the cosmetic appearance of lipomas are also a potential indication for excision.

Preparation for Excision of Lipomas

In general, preparation for excision of lipomas will involve the following steps:

  • A review of your medical history and a physical examination are performed to check for any medical issues that need to be addressed prior to the surgery.
  • You may need to undergo tests such as blood work and imaging to help detect any abnormalities that could compromise the safety of the procedure.
  • You will be asked if you have allergies to medications, anesthesia, or latex.
  • You should inform your doctor of any medications or supplements you are taking or any conditions you have such as heart or lung disease.
  • You may be asked to stop taking certain medications, such as blood-thinners, blood pressure meds, or anti-inflammatories for a designated period.
  • You should not consume any solids or liquids at least 6 hours prior to surgery.
  • You should arrange for someone to drive you home after surgery.
  • A signed informed consent form will be obtained from you after the pros and cons of the surgery have been explained.

Procedure for Excision of Lipomas

Excision of lipoma is a simple outpatient surgical procedure that is performed under local anesthesia. For deep-lying lipomas, the surgery may be performed under general anesthesia in an operating room. In general, the procedure involves the following steps:

  • You will be asked to lie down on the procedure table.
  • The area is cleaned and a local anesthetic injection is used to numb the skin overlying the lipoma.
  • Once the treatment area is numb, a suitable length incision is made based on the size of the lipoma.
  • The lipoma is then excised and the wound is sutured together in a fine line.
  • The scar is made as less evident as possible.
  • Sutures may be absorbable or they may be removed in 7 to 10 days post surgery.

Postoperative Care and Recovery

In general, postoperative care instructions and recovery after excision of lipomas will involve the following:

  • You will be transferred to the recovery area for observation and discharged home once your vital signs are stable.
  • You may experience pain, swelling, bleeding, or bruising over the treatment area. Medications are provided as needed to address these.
  • Instructions on surgical site care and bathing will be provided to keep the wound clean and dry.
  • Despite following appropriate measures, if you notice redness, pain, swelling, persistent bleeding, or any discharge from the sutured area, contact your surgeon immediately.
  • Avoid shaving if the lipoma is removed from the beard area until healed.
  • Avoid any make-up at the operation site until the wound is healed.
  • Do not wear clothes that might rub on the skin at the suture line.
  • Refrain from smoking for a designated period as it can hinder the healing process.
  • You will be able to resume your normal daily activities in a few weeks, but with certain activity restrictions.
  • A follow-up appointment will be scheduled to monitor your progress.

Risks and Complications

Excision of a lipoma is a relatively safe procedure; however, as with any surgery, some risks and complications may occur, such as the following:

  • Bleeding
  • Bruising
  • Wound infection
  • Scarring
  • Injury to blood vessels, nerves, or muscles
  • Allergic/anesthetic reactions
  • A collection of fluid or blood under the treatment area