Multiple Lipoma Treatment? How long does treatment take and what is the cost for that?

You most likely have the diagnosis of familial lipomatosis (other family members will have the same problem). Lipomatosis is believed to be a dominant trait in which multiple lipomas are present. Most are discrete, encapsulated lipomas on the trunk and extremitiesAlthough this condition is benign, many patients concerned with cosmesis seek removal of individual 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. The cost of excision of multiple lipomas depends on if it is done in the office or surgery center, technique, type of anesthesia, the time it takes to remove them, experience and qualifications of the surgeon, and geographic location.Find the most qualified plastic surgeon to take care of this problem.

Removing lipomas, whether single or multiple, usually results in a scar about the size of the lipoma in most surgeons' practice. Most of the patients who come to see me have a scar or two and have decided not to have any more removed by incision.

The current challenge is to remove lipomas with the minimum of scarring but still get them out without leaving much if any lipoma tissue behind. When lipomas are on the arms and forearm where the skin is thinner, this is easier to do than when they are on the back where the skin is thicker and the borders can be more difficult to find.

In my practice, lipomas are removed with local anesthetic. The lipoma outlines are marked on the skin before the surgical prep.  An access point is marked 2-3 cm away from the lipoma and situated to be equidistant if there is a group of 2-4 lipomas. Local anesthetic followed by tumescent local anesthetic is injected. This is done so there is enough fluid in the tissues to absorb the heat generated by the laser.

The access incision is about 1/4" long. The Smartlipo Triplex laser is used at 1440 nm, a wavelength which is highly specific for fat. The laser is used to melt the lipoma which is immobilized by the opposite hand. Gradually the lipoma decreases in bulk until it is not palpable, or minimally palpable.  A small alligator, open jaw clamp is introduced through the incision and gentle and careful removal of any fibrous encapsulated fatty tissue is done. The incision is then sutured with one or two sutures.

This procedure is repeated for each isolated lipoma or group of lipomas.

Depending on the size and location of the lipomas, up to twelve lipomas will be removed at one time. This can take 2-4 hours. Some patients have single large lipomas, usually on the mid or upper back.  When these are treated, a suction drain is placed to avoid seroma. The extremities are wrapped with a compression dressing.

The Smartlipo Triplex has a "Thermalguide" feature that monitors the temperature at the laser tip and can be programmed to alarm and shut off as the temperature rises to a set level. This minimizes the risk of a burn.

There are ICD-9 and procedure codes for removal of subcutaneous soft tissue lesions that can be submitted to the patient's insurance company, and some of our patients have been reimbursed partially for their procedures.

 

 

These multiple lipomas are usually associated with syndromes. I have removed as many as 40 of them at one time. Cost varies with the difficulty and time