Lipomas keep coming back after removal surgery. Any suggestions?

Question

I have had 3 lipoma removal surgeries within the past 2-3 years, in exactly the same location. The first two were 6 inches long and the third was 4. I had a disc fusion surgery about 4 years ago on my L5S1 and this is the same area where the lipomas are growing. I do not know if that has anything to do with it and the doctors can't give me any answers as to why they keep coming back.

Raffy Karamanoukian, MD, FACS · Answer

Lipomas are benign fatty tumors that occur under the skin and less commonly within the muscle. They are associated with mild discomfort and a lump underneath the skin. It is always best to talk to an expert plastic surgeon to determine whether the lipoma is possibly a cyst or a tumor or hernia. We would have to remove the lipoma to be sure that it is not something else and we usually do this by sending it to a pathologist for evaluation. If a lipoma is painful, then an exam is needed to make sure it is not compressing on a nerve or whether the diagnosis is different. Aftercare for a lipoma includes gentle compression and Plato’s Scar Serum twice daily on the wound.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Barbara L. Persons, MD, FACS · Answer

It is very unlikely that your lipomas are related to your disc surgery.In rare circumstances, fat can herniate through the thick tendon-like material ("fascia") and appear as a benign tumor (limp.)Lipomas related to the spinal cord are also rare, and are more related to malformations of spinal cord that would be detected in childhood. What you are describing is much more likely actual lipomas. Lipomas are common benign soft-tissue neoplasms. They consist of mature fat cells enclosed by thin fibrous capsules. Lipomas can occur on any part of the body and usually develop superficially in the subcutaneous tissue.

Lipomas present as soft, painless subcutaneous nodules ranging in size from 1 to >10 cm. They occur most frequently on the trunk and upper extremities. Frequently, patients may have more than one lipoma, and occasionally they may have a genetic condition (familial multiple lipomatosis) characterized by the development of multiple lipomas in several family members.

The diagnosis of lipoma is usually made clinically. If a suspected lipoma causes symptoms (pain or restriction of movement), is rapidly enlarging, or is firm rather than soft, a biopsy is indicated.

The treatment of lipomas, if needed because of pain, cosmesis, or concerns over diagnosis, is surgical removal of the fat cells and fibrous capsule. Recurrence of an excised lipoma--if all of it is removed-- is not common.1. ask if a biopsy was done, to ensure this is a lipoma2. if it is truly bothersome to you, removal may be possible if the entire capsule is excised3. As long as your lipomas are not cancerous, the only reason to pursue removing them is comfort and cosmesis. Seek a second opinion, and ask for your biopsy results.

Nelson Castillo, MD · Answer

Thank you for sharing your question and I am sorry to hear of your recurrent lipomas.  As recurrence is quite rare with complete lipoma removal I would recommend an ultrasound of the area to identify any residual lipomas that may simply have not been seen on removal of the first three lipomas.  Assuming there are no discrete fat tumors seen, you should not have the problem of a lipoma growing again.  Best wishes.

Lipomas keep coming back after removal surgery. Any suggestions?

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Lipomas keep coming back after removal surgery. Any suggestions?

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Everything you need to know about Lipoma Removal

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