Lipodissolve for Dissolving Fatty Tumors?

Mutliple lipomas can be a distressing cosmetic problem. In general, I would suggest that any individual suffering with this condition have at least one or two biopsied and sent for histologic confirmation that they are innocent, ordinary fatty tumors (lipomas).

Once proven, several possibilities exist for treating the remaining lesions. Piezotherapy is essentially a procedure in which, under local anesthesia, a small hole is punched out of the center of the lipoma followed by expressing the entire contents by manual pressure to the surrounding area. In general, the entire lipoma can be "delivered' through the small opening created (like a baby out of the birth canal) and then the resulting wound closed with a small dissolving stitch or two. Piezotherapy, in contrast to traditional, larger incision surgical removal of lipomas, leaves relatively tiny, often wounds and hence tiny nearly imperceptible scars.

Mesotherapy relies upon the injection of a fat dissolving material, such as desoxycholate, to shrink the fatty material under the skin and allow the body to reabsorb it. Lipodissolve was never approved in the U.S. and has even been removed from the markets in those countries, such as Brazil, where it was previously permitted. Commercially available FDA-approved injectable fat dissolvers suitable for mesotherapy are due to come to the American market over the next couple of years. In Israel, where I have a satellite practice, the use of extemporaneously compounded mixtures of desoxcholate and other agents is permissable, and I have enjoyed gratifying results with their use for small lipomas (as well as excess fat deposits under the chin and in the abdomen). 

Finally, Electrosubcision is a technique in which (following local anesthesia) an insulated radiosurgical probe is inserted drecetly through the skin into the fatty tumor and used to heat the fatty material, shrink it, and facilitate its reapbsorption by the surrounding tissue. 

In practice, whenever possible, I I prefer to test out each of these methods in order to determine which technique yields the optimum aesthetic benefit in a particular patient. Once this is ascertained the remaining lesions can be rapidly treated in that manner.

 

 

Multiple lipomas should be surgically removed and submitted for a biopsy. That is the most appropriate treatment.