I have a large lipoma (9cm) on my left bicep that my doctors tell me is underneath my muscle which is not as common as most.This being said, my left bicep looks noticeably larger than my right bicep so I am strongly considering having it removed for cosmetic reasons.My surgeon informed me that he would like to have an orthopedic surgeon do the surgery with him since mine is in such a difficult place and may be attached to nerves.Will having it removed leave a large scar all down my arm? I am only 18 so this concerns me.
Will Having a Large Lipoma Underneath my Bicep Removed Leave a Large Scar?
Doctor Answers 3
The large lipoma under the biceps is very unusual. There are lipomas that are intramuscular lipomas. I would get an MRI with contrast before contemplating surgery. May also consider a Biobsy first to make sure you are dealing with a benign lipoma. MRI will show where the nerves and blood vessels are in relation to the lipoma. In any way you will have a scar, but this should be your last concern.
Make sure your surgeon is an experienced Board Certified Plastic surgeon. If he needs a Hand/orthopedic surgeon then that is fine. If the MRI shows the lipoma is wraped around vital structures a BIOBSY is manditory before a plan of excision
Lipomas can be removed for cosmetic reasons using an extraction technique or liposuction and a half centimeter incision. The problem is proving that it's a lipoma. This can be assured if it's subcutaneous (below the skin but above the deep fascia and muscle) and looks and acts like a lipoma. If it's another layer deep (sub-fascial) or in the muscle (intra-muscular) or below the muscle (sub-muscular) then it could be something more serious and shouldn't be treated with incomplete removal as with liposuction.
In the situation you describe, I would suggest a biopsy of the supposed lipoma through a limited incision and if it's clearly a lipoma from the pathology report then remove the majority of it with liposuction and minimal scar and risk to nerves. If it's a lipoma it's not necessary to remove it at all or completely. If it's something else like a fibrosarcoma then it needs major surgery and cosmetic considerations are not of paramount importance.
9 cm lipoma removal
There will be a long scar from removing this but it is medically important to do and it won't go away any other way. Have a plastic surgeon and orthopedic surgeon work together for the best result.