My dad is going to have surgery to remove two lipomas from his flanks/lower back area. I think a lipoma is some kind of fat deposit, so I'm wondering is lipoma removal anything like liposuction? Is it a cosmetic procedure like liposuction, i.e. not covered by insurance?
Is Lipoma Removal Like Liposuction?
Doctor Answers 14
Contour defects from lipoma removal
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.
Liposuction will not remove completely a lipoma
Liposuction for lipomas is not the treatment of first choice. Liposuction does not completely remove lipomas. Small surgery is a better option
Lipomas are removed by excision
Lipomas are removed by surgical excision, not by liposuction. This should preferably be performed by a plastic surgeon to minimize scarring. In very specific circumstances where traditional surgery is contraindicated for various reasons, a patient may undergo lipoaspiration to improve symptoms associated with a lipoma.
This procedure should also be performed by a plastic surgeon and a tissue diagnosis should be made prior to invasive lipoaspirative surgery to improve overall safety and maintain the highest standards of care.
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Liposuction to remove lipoma
You can remove lipomas with liposuction but it introduces two potential problems.
The first problem is being sure to have tissue for pathology. While soft tissue masses that are otherwise asymptomatic can be a lipoma it can also be other things. Pathologic diagnosis is important and liposuction alone can make getting tissue for pathology difficult.
The second problem is recurrence. Lipomas can recur if not completely resected. They tend to have defined borders and can be "shelled out". Liposuction makes complete removal more difficult and may increase recurrence
I hope this helps
Great questions. Unfortunately a lipoma is different...
Great questions. Unfortunately a lipoma is different from regular fat. Liposuction will tend to remove most of the lesion but it will likely come back. The best treatment is to make a small incision over the lipoma and remove the lesion. At times, lipoma removal is not considered cosmetic. While there is never a guarantee of insurance coverage, it is prudent to check with your insurance company before removal as there are circumstances that removal is covered by insurance.
Liposuction not best choice for small lipomas
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
Is Lipoma Removal Like Liposuction?
I remove lipomas such as these with a combination of SmartLipo laser treatment followed by lipo-aspiration.
A biopsy can be done if there is any concern that the lesion is not benign. Malignant transformation of a subcutaneous lipoma is very uncommon. Google "liposarcoma" and pick the Medscape article for information in depth about lipomas and liposarcomas.
Liposuction can and has been done, but with the advent of laser assisted liposuction devices, the risk of recurrence and depression of the skin is greatly reduced. If liposuction is done, the patient has to accept that not all the lipoma will be removed and there is a greater chance of recurrence than with direct excision. Direct excision is usually successful, but there is still a chance of recurrence.
The laser first melts the fatty tissue of the lipoma and is very good at getting through the dense fibrous network that holds the fat in some large lipomas. Then after the endpoint of skin smoothness and no palpable remnants, a blunt lip-aspiration cannula is used to gently remove any tissue and fluid from the space formerly containing the lipoma. The 5 mm incision can be closed or left open for drainage.
Lipoma Removal with Liposuction
Lipomas can usually be easily removed by making a small incision in the skin and "pushing" the lipoma out through the opening. Liposuction is not he preferred method of treatment.
Lipomas are most often completely removed: Reason why ...
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
Lipoma removal: excision vs. liposuction
Lipomas are usually removed by direct excision. This means an incision is made directly over the lipoma, and the lipoma is removed. Frequently the incision can be a smaller than the underlying lipoma.
Large lipomas are occasionally removed by liposuction.
Advantages of direct excision:
1. Tissue available to send for pathologic diagnosis.
2. Recurrence rate is lower than with liposuction because excision is more likely to remove all abnormal cells.
3. Insurance will usually cover.
Advantages of liposuction:
Most patients choose direct excision.