I Have Multiple Lipomas on my Thighs and Hips. They Are All Very Tender to the Touch, but a Couple in Particular on my Right?

thigh above my knee are very painful. I get burning pain and numbness in the area. Should I see a physician and get them all removed at once under a general anesthesia?

Doctor Answers 4

Painful Lipomas

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
You may have Dercum's Disease also called Adiposis dolorosa. The following info is from Wikipedia and may be helpful to you: "Four cardinal symptoms have sometimes been used as diagnostic criteria. 1) painful, fatty lipomas (benign fatty tumors) across anatomy; 2) obesity, frequently in menopausal age; 3) weakness and fatigue; 4) emotional instability, depression, epilepsy, confusion, and dementia. However, as it is unclear which symptoms are cardinal and which symptoms are minor signs in Dercum’s disease, it is unclear which should be used as diagnostic criteria. Researchers have proposed a 'minimal definition' based on symptoms most often part of Dercum's disease: 1) Generalized overweight or obesity. 2) Chronic pain in the adipose tissue.The associated symptoms in Dercum’s disease include obesity, fatty deposits, easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, diabetes, bloating, constipation, fatigue, weakness and joint and muscle aches"

You most likely you also  have the diagnosis of familial lipomatosis (other family members will have the same problem). Lipomatosis is believed to be a dominant trait in which multiple lipomas are present. Most are discrete, encapsulated lipomas on the trunk and extremities.Although they may increase with weight gain, weight loss doesn't improve them in my experience.
Although this condition is benign, many patients concerned with cosmesis seek removal of individual tumors. Treatment can include simple excision, endoscopic removal, or liposuction if large. Liposuction, whether laser Liposuction or traditional will leave some of the lipoma cells behind which over time will probably recur though it may take years. There is nothing special about laser lipo vs regular liposuction to take care of your problem. I published the first article on lipo removal of large lipomas and believe this technique can be used knowing that you will probably have to repeat it when the lipomas eventually recur. However, this may be a reasonable option to minimize the number of scars.
Find the most qualified plastic surgeon with experience with this problem to discuss your options and to take care of you.

Both Options Reasonable

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Lipomas are typically removal if they are uncomfortable or in a visible location. Some patients worry about a growing mass on their bodies.  Fortunately, lipomas are a benign condition. Removal is fairly straight forward depending on the size and location.  It is reasonable to either remove them all at once under anesthesia or in a staged fashion under local.  A more definitave answer would require examination. Good luck.

Painful Lipomas as Well as Multiple Lipomas on the Thighs and Hips

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The reason patients come to me is because they either do not like the appearance of some of their lipomas or because some of them are tender. Usually there is a mixture of the two reasons.  The large ones on the back or shoulder usually are removed because they are unsightly. 

Lipomas on the extremities are more likely to be tender. If they are growing against sensory cutaneous nerves and putting pressure on them they can be uncomfortable or painful.

Lipomas on the extremities can be removed with local tumescent anesthetic in the office operating room.  They are broken down or melted with the Smartlipo Triplex 1440 nm laser and the remnant is removed with low vacuum 1.4 mm liposuction and a small alligator clamp. 1-20 can  be done in this way at the same time.

Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 54 reviews

Multiple painful lipomas

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I would definitely recommend seeing a plastic surgeon, first, to determine that they are, in fact, lipomas.  Lipomas usually are not painful.  If they are lipomas and fairly superficial then you could remove them a few at a time under local anesthesia in an office setting or you could remove them all under general anesthesia.  Again, the best approach should be determined by your examining physician.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.