Lipoma under jawline (Photo)

Question

I have a lipoma about the length of the tip of my thumb to the first knuckle under my jawline. I am concerned about whether the resulting scar would be cosmetically worse than if I left it alone. My PCP suggested that a new procedure was going to become approved for removing lipomas in the coming future that would have a smaller scar than from an incision. Any advice you have would be appreciated. PS Is this procedure normally covered by insurance or is it considered cosmetic? Thank you, Marc

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

Nelson Lee Novick, MD · Answer

A relatively large mass under the jawline should not simply be clinically diagnosed as a lipoma. A workup to establish and confirm the diagnosis is strongly recommended before any treatment is undertaken. If the mass indeed proves to be a lipoma, there are several therapeutic approaches that may be considered. Conventional scalpel surgery is certainly one option, but entails a large cut and a longer healing time.  MIE or minimal incision extraction (aka as "Squeeze Delivery Excision") is an alternative approach where a small punch opening is made in the center of the mass and the entire lipoma is essentially squeezed out of the small opening created by a cookie cutter-type cutting instrument known as a "punch." The opening that results is then much smaller and requires many fewer stitches when compared to the closure necessitated by performing ordinary elliptical scalpel excision surgery. I have been successfully using this approach for lipomas all over the body and face for well over two decades.Finally, a new product, Kybella, an injectable fat dissolver FDA-approved for shrinking double chins, may be considered as  a completely nonsurgical approach to treating a submental lipoma.

Stephen Prendiville, MD · Answer

A mass in the submandibular space should not be presumed to be a lipoma.  This requires a diagnostic workup by an Otolaryngologist who specializes in head and neck surgery.  The incision for removal of a mass in this area is placed in a horizontal skin crease and usually heals very nicely.

Samir Shureih, MD · Answer

First and foremost the proper diagnosis should be made. There are many important structures and glands in that same area.Make sure it is a lipomas and not a submaxillary gland. The incision is the least of the problems. the area is full of vital structures that requires an incision in the lines of the neck

Alan M. Engler, MD, FACS (retired) · Answer

Lipomas can normally be removed using very small incisions and for an established lipoma that is currently the treatment of recommendation.  Newer techniques, including injection of materials that liquefy fat, may be applicable but are not yet the standard.But for a mass of the neck, you have to make sure it's a lipoma.  There are other things it could be, and there are a lot of things in that region (like blood vessels and lymph nodes) that would be unfortunate to mistake for a lipoma.You should see your physician and a board-certified plastic surgeon in consultation, for both diagnosis and treatment options.I hope that this helps and good luck,Dr. Alan EnglerMember of #RealSelf100@RealSelf

Lipoma under jawline (Photo)

Answers (5)

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