A lipoma is a common, non-cancerous growth composed of mature fatty tissue that develops just beneath the skin. These soft, rubbery, and typically painless lumps are the most frequent type of benign soft tissue tumor. While a lipoma is harmless and does not usually require treatment, people often seek removal if the growth is large, causes discomfort, or presents a cosmetic concern. Removal involves an initial medical assessment to confirm the diagnosis, followed by a procedure performed by a specialist based on the lipoma’s size, depth, and location.
Initial Medical Evaluation
The initial evaluation begins with a visit to a Primary Care Physician (PCP) or General Practitioner. The assessment relies on a physical examination, where the doctor checks the lump’s texture, size, and mobility. A classic lipoma feels soft and doughy, moves easily under slight pressure, and is usually less than two inches in diameter.
The goal of this evaluation is to differentiate the benign lipoma from other possibilities, such as a cyst or, rarely, a malignant tumor like liposarcoma. If the lump is unusually large, fixed in place, growing rapidly, or causing pain, the physician may order imaging tests. An ultrasound or Magnetic Resonance Imaging (MRI) scan provides a detailed view of the mass, confirming its fatty composition and depth. If the diagnosis remains uncertain, a biopsy may be performed before removal is scheduled.
Office-Based Removal Procedures
For the majority of small, superficial lipomas, removal can be managed in an outpatient or clinic setting. Dermatologists, who specialize in skin and subcutaneous tissues, are often the primary specialists for these routine excisions. They frequently perform the procedure, known as surgical excision, directly in their office.
The procedure uses local anesthesia, such as lidocaine, to numb the area, ensuring the patient remains comfortable and awake. A small incision is made directly over the lipoma, which is then separated from the surrounding tissues and removed completely. The excised tissue is typically sent to a lab for pathological examination to confirm its benign nature. Surgical excision is considered the most reliable method for preventing recurrence, as the surgeon aims to remove the entire fatty mass and its fibrous capsule.
Specialized Surgical Interventions
When a lipoma is large, deeply situated, or located in a cosmetically sensitive area, specialized surgeons are required. General Surgeons often manage lipomas that are large, deep beneath the muscle fascia, or those requiring general anesthesia for complete removal. Their training prepares them to handle complex cases and potential complications arising from deeper dissection.
Plastic Surgeons are sought after when the lipoma is located on highly visible parts of the body, such as the face or neck. Their expertise focuses on meticulous tissue handling and advanced closure techniques to minimize the resulting scar. For large lipomas, the surgeon may employ liposuction to aspirate the fatty contents through a smaller incision, which can improve the cosmetic outcome. However, liposuction alone may carry a higher risk of recurrence because it can be difficult to remove the entire lipoma capsule, potentially leaving behind cells that may regrow. The choice of specialist depends on the initial medical evaluation and the patient’s concerns regarding complexity and scarring.