Is Lipoma Removal Like Liposuction?

Proper excision of a lipoma does neccesitate an incision in the skin. Very large lipomas will leave a large indentation in the surrounding tissue once the lipoma is removed. For this reason, it is important to have this done by a plastic surgeon who is familiar with and able to properly perform reconstruction of the deeper tissues. Although liposuction is possible for removing lipomas, it is only used in rare situations. Additionally, liposuction will not completely remove the lipoma and therefore will increase the chance of the lesion re-growing.

A Lipoma is simply a lump of fat, firmer in nature than the surrounding fat that acts like a benign tumor that keeps on growing even if you stay at the same weight. It is directly removed directly by surgery. Rarely for a huge lipoma, liposuction can be used but this increases the risk for recurrence as some lipoma cells remain.

Here is an article you can read about using liposuction for Giant Lipomas that I wrote for Annals of plastic surgery    :Nichter LS, Gupta R*: Liposuction of Giant Lipoma. Annals of Plastic Surgery 1990; 24:362-365

Using power-assisted liposuction I debulk them through a 3/8" incision and then remove them completely with scissors dissection, traction, and further dissection and extrusion. Most lipomas are very typical, both by appearance and history. If there is any concern that they are not benign, a biopsy or MRI can be done before proceeding, usually for lipomas over 5-6 cm, or any that  have had rapid growth.

I removed a 10 x 12 cm gradually enlarging lipoma on the right waist.  The access was through a 3/8" mm incision over the most prominent part of the lipoma.

The lipoma was outlined and anesthetized with tumescent local anesthesia. 

The lipoma is separated from the overlying skin with scissors dissection. A small liposuction cannula with power-assisted liposuction is used to soften and debulk the lipoma. Then the rest of the lipoma is completely and gradually removed using traction with clamps, dissection and extrusion. When removal is complete, the cavity is inspected with a fiberoptic headlight. A drain is placed for a week and the patient can return to non-strenuous activities and may shower any time.

For multiple lipomas of the chest or arms, a small stab incision is made with a #11blade. This 1/4-3/8" incision is usually enough to remove any lipomas up to about 3 cm by simple dissection and extrusion. I have done as many as 80 lipomas at a time with this method

The video shows how even a giant lipoma can be removed with a 1/2" incision.

 

You run the risk of lipoma recurrence if they are not completely removed. I have used liposuction in select cases for lipomas that are very difficult to get to or intimately associated with the facial nerve. However, there is a trade off that the lipoma might recur and require additional treatment. Therefore, for easily accessible lipomas they are typically removed in their entirity.Stephen Weber MD, FACS

Lipomas are harmless and can be ugly bumps that are noticeable but the ugly scar from excision surgery can look worse.
Power assisted liposuction with a 2 mm canula can debulk the fat mass and then a currette scraping of the pseud lining finishes off the job under local anesthesia with no scar at all for about $350 for a small lipoma.
.