What Are my Lipoma Treatment Options?

Question

I might have a lipoma and I am just curious about what kind of lipoma treatments exist.  Is surgery the only option for lipoma removal or do people with lipomas have other options?

Robert M. Lowen, MD · Answer

These benign fatty tumors are removed because they are unsightly, uncomfortable or enlarging.

	These tumors are typical in appearance: soft to rubbery, not fixed to skin or underlying structures, and slow growing.  If there is skin change, ulceration, dimpling or fixation, they should be biopsied to rule out a malignant liposarcoma.  Liposarcomas of the skin are usually intradermal and not like lipomas.  Liposarcomas arising as malignant tumors are found most often in  deeper tissues such as muscle or in the back of the abdomen.

	Malignant  transformation of a lipoma to a liposarcoma is rare.  If there is concern about a lipoma being malignant, then an excisional biopsy or fine needle biopsy can be done.

	Once the decision is made to remove the lipoma, it can be done by direct excision which leaves a scar of varying length; liposuction, which will leave some cells behind, or laser melting which may also  leave some cells behind. However, this does not occur so often as to be an inconvenience, since the lipoma is slow growing and another procedure can be done.  Removal through laser or liposuction, my preference being laser, leaves only a 5 mm scar which can be remote from the lipoma and hidden in a skin crease if possible.

	If a patient has multiple small lipomas,which many do, on the arms, chest, trunk and legs, surgical excision leaves so many scars that patients want an alternative, less scarring treatment, even if it does have some trade-offs.  Even debulking multiple lipomas without complete removal is worthwhile because it is not disfiguring.  Many patients with familial lipoma histories keep getting lipomas.  This problem can be controlled with laser melting.

Matthew Richardson, MD · Answer

Lipomas are very common growths, and are usually removed with surgery. If they are not causing any problems, they can often be observed if the patient does not desire removal. Other treatment options do exist, such as liposuction, laser liposuction, or even injections to dissolve the fat cells, but surgical excision is generally recommended to obtain a pathologic diagnosis.
All the best,

Larry S. Nichter, MD, MS, FACS · Answer

Although this condition is benign, many patients concerned with cosmesis seek removal of individual lipoma 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.

Afshin Farzadmehr, MD · Answer

Lipoma removal is usually a simple procedure under local anesthesia. Majority of lipomas can be removed like an "marble" from a small incision. This takes about 5 minutes to perform. As a dermatologist and cosmetic surgeon I close the incision with disolvable sutures so there are no sutures outside for the best cosmetic result. There are some Lipomas that are larger and more fibrous and attached which require more work. The cost for removal is about $100.

William Bruno, MD · Answer

A lipoma is a benign (non-cancerous) fatty tumor which can appear almost anywhere on the body.  They are usally firm and round and can become unsightly, requiring removal primarily for cosmetic reasons.  Most can be removed under local anesthesia as an outpatient with minimal pain and quick recovery. The specimen should be sent to a pathology lab to confirm the diagnosis. They are usually removed by plastic surgeons or dermatologists. The entire lipoma, including it's outer lining, must be removed to prevent recurrence.

	Please consult with a board certified surgeon prior to your lipoma removal.

	Best wishes,

	Dr. Bruno

Raffy Karamanoukian, MD, FACS · Answer

Lipomas are benign fatty tumors composed of adipocytes (fat cells). The most definitive treatment for a lipoma is surgical excision using a very small incision placed on the skin. This is a common procedure that I perform in an outpatient setting.

Kevin Brenner, MD, FACS · Answer

Lipomas are usually removed because of a change in characteristic (i.e increase in size), compression of a critical structure (i.e. compresses a nerve) or for aesthetic reasons (i.e. don't like how it looks). Frequently, they can be excised easily. Liposuction of lipomas is possible, but increases the chance that they will regrow since they are not removed completely. In rare situations, a mass that is suspected to be a lipoma turns out being a malignant (cancerous) mass. This is why any suspected lipoma should be biopsied and assessed microscopically by a pathologist.

Robert S. Backstein, MD · Answer

Nearly all lipomas can be removed under simple local anesthesia in a procedure that takes less than half an hour. I treat nearly all lipomas this way and always prioritize using the tiniest incision possible so as to leave the smallest possible scar. Excision of this sort has a negligible recurrence rate and afford the opportunity to send each growth out for biopsy in order to confirm the diagnosis. Liposuction is another technique to surgically remove lipomas but the process breaks up the lipoma internally and thus is much more prone to leaving bits behind with an associated high recurrence rate compared to excision. Using a very tiny incision technique, surgical excision need not leave a significantly bigger scar than liposuction does and given the very low recurrence rate and tissue specimen for biopsy, it is always my treatment of choice. I do not believe in offering holistic remedies often discussed in chat rooms etc, simply because they are not backed up by scientific evidence.

Andrew Kaufman, MD · Answer

Surgery is the best option for lipoma removal. Liposuction has been used, but in my opinion it is a less optimal choice as some of the cells which constitute the lipoma may be left behind (and therefore, the lipoma may recur). Many lipomas can be removed with a relatively small incision so its important to discuss with your doctor how the surgery will be performed and how large the surgery scar will be.

Pat Pazmino, MD, FACS · Answer

Lipomas are soft and the localized areas of fatty growth. As lipomas lived deep to the skin, treatments such as creams or lasers will have no effect on them. If the lipoma is concerning you and you would like it removed, the best treatment is surgical excision through a small incision that is placed in an inconspicuous area so that it is not easily noticeable and heals well.

What Are my Lipoma Treatment Options?

Answers (15)

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