Is this a lipoma, and would it be worth it to have removed? (Photos)

You have a swelling that on the photo looks like it could be and probably is a benign lipoma. Before removal, you would have an MRI. Then you could have it removed with whatever size incision your local plastic surgeon uses.
I use the Lowen technique which completely removes the lipoma leaving about an inch scar. It is done under local anesthesia in the office operating room. Depending on the size of the lipoma, a drain may be placed. You can see an example in RealSelf in the link to this answer.

I recommend you get a repeat ultrasound. It is most likely a lipoma and if you are having pain with it then it should be removed.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your detailed explanation and for providing the image.

Based on your description and the appearance in the photo, this may indeed be a subcutaneous lipoma—a benign, soft fatty lump that often becomes more visible when muscles are flexed or stretched (such as when lifting your arm overhead). Lipomas are usually painless but can become sore or bothersome with physical activity or if they press against nerves or surrounding tissues.

Key Points from Your Case:
Duration: Present for 3 years with no major changes—this is consistent with a benign growth like a lipoma.

Intermittent soreness during workouts suggests local tissue or muscular interaction.

Non-tender and not fixed to the skin, and only visible with certain movements, which also leans toward a soft tissue mass like a lipoma or possibly a muscle herniation.

Ultrasound was inconclusive, possibly due to the technician focusing only on lymph nodes rather than soft tissue evaluation.

Next Steps:
Repeat Imaging: Consider requesting a high-resolution ultrasound specifically focused on soft tissue (ask for "evaluation of a subcutaneous mass, not just lymph nodes"). Alternatively, an MRI can offer greater detail, especially if the area is deep or near muscle.

Biopsy or Removal: If the mass becomes more uncomfortable, grows, or limits your movement, surgical removal may be considered. It’s usually a minor outpatient procedure if it is indeed a lipoma.

Is It Worth Removing?
If the mass is:

Stable, non-painful, and not growing, it may not require removal.

Causing discomfort, especially during physical activity, or if it's cosmetically bothersome, then removal could be worth considering for peace of mind and function.

Although it appears benign, confirming the nature of the mass with imaging is the right path forward to rule out anything unusual and guide your decision confidently.