Is It Possible to Completely and Thoroughly Remove a Lipoma?

Question

I have a rather large lipoma on my upper back.  I had a similar mass removed surgically several years ago, but it returned.  This is unsightly, and I would very much like to have it removed if there is any way to ensure that it will not return.  Thank you for your time and expertise.  Photo attached.

Otto Joseph Placik, MD · Answer

Yes, it is possible but you may need to obtain an MRI to rule out deep involvement. Generally this is the concern with liposuction treatment of a lipoma. It rarely removes all the tumor. Clearly the advantage is the minimal scars. A larger scar affords greater visibility and an opportunity to completely remove the mass.

Raffy Karamanoukian, MD, FACS · Answer

Lipomas are benign fatty tumors that occur under the skin and less commonly within the muscle. They are associated with mild discomfort and a lump underneath the skin. It is always best to talk to an expert plastic surgeon to determine whether the lipoma is possibly a cyst or a tumor or hernia. We would have to remove the lipoma to be sure that it is not something else and we usually do this by sending it to a pathologist for evaluation. If a lipoma is painful, then an exam is needed to make sure it is not compressing on a nerve or whether the diagnosis is different. Aftercare for a lipoma includes gentle compression and Plato’s Scar Serum twice daily on the wound.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jeffrey J. Roth, MD, FACS · Answer

Yes, one can remove a recurrent lipoma.  This is the preferred way, as opposed to liposuction, etc.  They can still return.  Sometimes one cannot get all of the tumor.  Sometimes there may be a small tumor nearby that then grows close to the same area and then is perceived as a recurrent lipoma.   Re-do surgery is often more challenging as the tissue planes may not be as pristine.  Most often we go through he same incision so as not to create a new one.
Not a bad idea to get an MRI to see the extent of the lipoma.  I would also send this tissue to pathology to be on the safe side.

Tom J. Pousti, MD · Answer

Thank you for the question and picture.

	Yes, it is possible to completely remove the lipoma.

	Given your history, it may be in your best interest to have imaging of the lipoma area done prior to repeat excision. An MRI study may be helpful to evaluate the extent of the lesion.

	Best wishes.

Peter A. Aldea, MD · Answer

Hi Amy,
Yes. Absolutely.
To do so you and your surgeon need to understand WHY did it recur and how FAST did it recur? Were parts of it left behind last time? Was liposuction used which would make it more likely?
I would do either a CT or MRI to make sure it does not go deeper than the underlying shoulder blade and back muscles. I would have the pathology slides from the last removal looked at again asking if it is possible that this is not your basic Lipoma but something else.
Finally, I would not have waited as long as you had and allowed it to grow so large as this has stretched the overlying skin AND caused a crater beneath which will be seen when this mass is removed.
There are several good guys in Knoxville and I'm sure all are capable of taking care of this for you.
Good Luck.

Hisham Seify, MD, PhD, FACS · Answer

Reccurent lipomas could be exised completely if a proper imaging study is used prior to surgery to identify any deep portions. Since you already have a previous scar ,i would use this scor as my access incision. A CT or MRI would be ideal to make sure no other portions are missed.

Scott E. Kasden, MD, FACS · Answer

These are not a cancer, so this is the good news.
They can be completely removed, but really the only way to be sure is that they don't return.  Therefore, there can be no guarantees.  It is worth trying again.
sek

Theodore Katz, MD, FACS (retired) · Answer

No one can guarantee that a lipoma, even though it is benign, will not recur even after the first excision which is the best chance a surgeon may have to completely remove it. I have had occasional patients who have had recurrences and then had a re-excision once or twice and the lipoma then stayed away. Surgery is the best approach, especially in the area of your lipoma. Go to a board certified plastic surgeon and be sure that the tissue removed is examined thoroughly microscopically.

Arnold R. Oppenheim, MD (retired) · Answer

Lipomas are benign tumors of adipose tissue. Benign does not mean that a lesion cannot recur and grow. However, it should not do so if the whole mass has been removed. 
  Surgery would still be the best approach. The pathology should be reviewed. There are variants of the common lipoma such as the pleomorphic lipoma ( your location would be typical for this entity) which are more cellular and have a greater tendency to recur.

Is It Possible to Completely and Thoroughly Remove a Lipoma?

Answers (9)

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