Swelling After a Lipoma Removal

Swelling normally peaks at three days and resolves by ten days.  A hematoma may significantly delay this.  If it persists and is fluctuant, it can be repeatedly drained.  Best wishes.  Knowledge is power.  Luis F. Villar MD FACS

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

Back Seroma Management
What you describe is a seroma, or collection of serum in the empty raw space where the lipoma used to be. The back seems to have a propensity to develop these. Fortunately is resolves but some are persistent and take a long time. Occasionally a new drain needs to be placed. An elastic vest is helpful, decreasing back movement associated with exercise, and in rare cases injection of tetracycline with a drain in place is required (see below reference).

If a large lipoma is removed, it leaves a large empty space. That space can collect fluid, called a seroma or hematoma. A seroma is just a collection of lymph fluid, and a hematoma is a collection of blood. Either would be best to drain. Using compression over the area is the best way to manage this. If it continues to collect blood, then opening the incision and finding the vessel bleeding would be the best solution. Hope this helps.

It is very common to have swelling after a lipoma removal, especially if it was a big one on the back.  Swelling can easily take several weeks to go down.  When removing large lipomas on the back I typically place a drain in for a few days to help remove that extra fluid that collects and to minimize swelling.  I do not recommend you take any medications to reduce the swelling, and especially avoid blood-thinners such as ibuprofen or aspirin.  Give it a good 3 weeks and if it is still not improved by then, I suggest you follow up with the physician again.