Feasibility of Removing Unencapsulated Lipomas Via Liposuction?

Question

I was diagnosed with either type 2 madelung's (gp) or lipoedema (specialist in CA) (got a biopsy done and lumpy nodular fat). It was recommended that I seek liposuction for the affected areas. The specialist in CA seemed to recommend bodyjet due to some studies out of Germany. My gp indicated he thought local only true tumescent was the way to go. I would like advice on seeking a doctor who will treat the condition and what method would be ideal.

Brent Moelleken, MD · Answer

I would concur with many of my colleagues that it is a bad idea to remove lipomas with liposuction.
Lipomas are abnormal growths of cells.  Although the vast majority of them are non cancerous, lipomas can be invasive.  Removal of them is usually straightforward for a board certified plastic surgeon, even if they are under muscles, nerves, or next to bone where specialized training is required for their removal.
Recurrent lipomas are much harder to remove and more dangerous because of scar tissue that obscures borders, hides nerves and masks recurrences that can be very difficult to remove completely without some disfigurement that always occurs when you don't know where the remnants of this benign tumor are sitting.
Don't take the cheap way out.

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

Unencapsulated Lipomas can be reduced by liposuction and may be a valuable treatment option for Madelung's disease - also called Benign symmetrical lipomatosis if in areas where critical anatomical structures such as nerves or major blood vessels live (for instance the back of the neck and upper back might be areas where this could be used.) Benign symmetrical lipomatosis disorder is characterized by  multiple, symmetric, nonencapsulated fat masses in the face, neck, and other areas. Typically, this entity has been related to the presence of three anterior bulges in the neck. I was the first to describe this technique on a giant lipoma of the back (see Nichter, LS:  Annals of Plastic Surgery  1990 Apr;24(4):362-5. Liposuction of giant lipoma). I do agree however with other authors that recurrence of this problem is increased with liposuction but none-the-less may be a valuable method of treatment for patients with particularly large lipomas in anatomically favorable locations, especially unencapsulated lipomas.

	Here is some background information on your particular problem: Benign symmetric lipomatosis, also called Madelung's disease usually occurs in adults from ages 30 to 60 years old. It is somewhat rare with an incidence of about 1 in 25,000. It is 15- 30 times more likely to occur in males and thought to be non inherited..  More than 90% of the patients have associated alcoholism and stopping alcohol ingestion can stop the progression of this process in many patients. Resection is the most common approach to management but may not be currative, which is why liposuction may be considered as a management tool in areas that do not have structures that can be readily damaged by this technique. Mesothrerapy has also been described as a non-invasive technique but should be considered experimental at this time.

Ricardo A. Meade, MD · Answer

Your lipomas will continue to recurr. The technique of removal should not be determined by a family practitioner. No trendy technique in liposuction has proven to be superior in this circumstance so don't be fooled. Regardless of the technique, your result should be very reasonable so select your plastic surgeon by first ensuring that he's board certified by ABPS.
Best Wishes,
DoctorMeade

Otto Joseph Placik, MD · Answer

I, in agreement with the other surgeons below, do not necessarily feel that waterjet offers superior results when compared to other techniques for fat extraction.
the advantage to liposuction  removal of lipomas are the limited scars. The disavantage is the likelihood and inevitablity of incomplete removal. When removing tumors, benign or maligant, we generally prefer to excise a tumor for defnitive treatment. When our goal is not necessarily curative, we sometimes perform a debulking procedure. Tumor is left behind and has the potential to grow back (recur).
Using liposuction is more of a debulking procedure rather than a curative procedure.

Farbod Esmailian, MD · Answer

Not the best way to go about removal of lipomas.  As long as you are willing to accept a high recurrence rate then go for it.  Otherwise the best method to decrease your recurrence rate would be to remove it via excision.
Good luck.

Feasibility of Removing Unencapsulated Lipomas Via Liposuction?

Answers (10)

Answer: Liposuction for lipoma removal

Answer: Liposuction for lipoma removal

Answer: Liposuction for Lipomas

Answer: Liposuction for Lipomas

Recommended reading

Everything you need to know about Lipedema Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

Feasibility of Removing Unencapsulated Lipomas Via Liposuction?

Answers (10)

Answer: Liposuction for lipoma removal

Answer: Liposuction for lipoma removal

Answer: Liposuction for Lipomas

Answer: Liposuction for Lipomas

Browse related questions

Recommended reading

Everything you need to know about Lipedema Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.