Lipoma Surgery – Skin Lump Removal Sydney by Dr Kernohan
Lipomas are skin lumps or common benign fat tumors that develop between the muscle and skin. They are not cancerous, and they’re extremely unlikely to harbor malignancy. Nevertheless, they can grow into a big mass under the skin that can become annoying or painful. Lipoma surgery can help.
Surgery to remove lipoma is usually straightforward and can be done with liposuction or surgical excision. However, extreme care must be taken by surgeons to achieve the optimal cosmetic outcome.
Sydney Specialist Plastic Surgeons Dr Varun Harish, Dr Hari Alani and Dr Michael Kernohan perform surgical removal of lipomas using different techniques that prioritise cosmetic outcomes and minimal scarring.
They perform a range of Skin Surgery in locations across Sydney, Southwest Sydney and Southern Highlands. The Pure Visage Plastic Surgery Clinic is located in Gregory Hills.
What is a Lipoma?
A lipoma is a benign fatty tumor that develops on the body’s surface, usually between the skin and the underlying muscles. It is made up of mature adipose tissue (fat tissue) surrounded by blood vessels and fibrous tissue. Lipomas are also called skin lumps. Lipomas are usually not a cause of concern but can be painful or unsightly.
The most common location for lipomas is the:
- neck and shoulders
- buttocks and thighs
- arms and legs
- chest and abdomen
- face and scalp
Dr Kernohan removes skin lumps. He performs lipoma excision procedure and liposuction to remove the annoying fatty growths.
So how do you know if that skin lump growing on your neck is a lipoma or something else? Lipomas are usually:
- Mobile – you can move them under the skin with your fingers
- Slow growing
A hard, painful, or rubbery mass growing under the skin might not be a simple lipoma and should prompt seeking a medical evaluation as soon as possible.
The exact mechanism behind the formation of a lipoma remains unknown. Some scientists believe that lipomas start as small deposits of fat cells that then multiply and expand over time. Others think that lipomas begin as clusters of normal fat cells that gradually increase in size. Still, others believe that there is no single cause, but rather a several risk factors contribute to the development of a lipoma. These include genetics, hormones, diet, weight gain, obesity, and trauma.
There are several types of lipomas, all are benign and can be treated by surgical excision:
- Conventional lipomas: these are the most common type of lipoma – formed of normal fat cells.
- Angiolipoma: these benign tumors are formed from adipose tissue and blood vessels
- Fibrolipoma: a mixture of fat cells and fibrous tissue
- Hibernoma: the fat formed in this type of lipoma is brown. Brown fat serves to maintain body temperature.
- Myelolipoma: This is a type of lipomas that contains blood cell producing stem cells
- Spindle cell lipoma: This refers to the elongated shape of the fat cells in this type of skin lump
- Pleomorphic lipomas: This classification is also based on the shape of the fat cells. Pleomorphic means heterogeneous – different sizes and shapes.
From the outside, all lipomas look and feel the same. They are all skin lumps that bulge from under the skin. So the diagnosis of lipoma and determining its type is usually done intra-operatively or under the microscope.
A lipoma is a benign tumour and is very unlikely to develop into cancer or cause any complications. Nevertheless, lipoma removal procedure can be an option for:
- Cosmetic reasons: larger lipomas and giant lipomas can cause deformity especially if the fatty lump grows in a visible area of the body, like the neck, face, or arm
- Pain: As the fatty tissue grows, it sometimes presses on surrounding soft tissue, leading to pain and discomfort. A painful lipoma is an indication for lipoma removal surgery
- Suspicious signs: Rapid change in size, new onset of pain, and signs of inflammation might warrant surgical treatment of lipoma
The type of surgery to remove lipoma is usually determined by the size and location of your skin lump.
If you decide on getting your lipoma removed, Dr Kernohan will help you choose between a lipoma excision procedure and liposuction:
1. Lipoma excision procedure
This is the surgical removal of the lipoma. Dr Kernohan will first perform an incision on the overlying skin covering your lipoma. Then, he will separate the adipose tissue (fat) from the surrounding subcutaneous tissue and muscles. He will then try to remove the lipoma in one piece (en bloc removal).
The remaining cavity will be closed and the skin sides approximated with sutures. If the lipoma is big and has left excess skin, the extra skin will be cut out to achieve the optimal cosmetic outcome.
Lipoma excision procedure can be done with local or general anaesthesia, depending on the size and location of your skin lump. Deep lipomas, larger lipomas, or those located in tricky places (like the neck or face) are usually removed with the help of general anaesthesia (you will be put to sleep). Smaller lipomas located in accessible areas (like the forearm) can be removed with local anaesthesia alone.
The recurrence rate after surgical excision of lipoma is estimated to be around 1-2%. If a lipoma recurs, you will have to have surgical removal again.
2. Liposuction to treat a Lipoma
Liposuction is less frequently used to treat lipoma compared to surgical excision. The liposuction method entails the use of a liposuction probe (a metallic catheter) to suck out the lipoma fat from under the skin.
Removal of lipomas by liposuction has one great advantage: less scarring. The liposuction probe is introduced into the lipoma through a small puncture wound that leaves a very tiny scar.
Nevertheless, fat suction is also thought to provide less ideal results, incomplete resection, and a higher recurrence rate compared to complete surgical excision. This is why many surgeons prefer the traditional lipoma excision procedure.
Some surgeons also opt to combine liposuction with surgical removal of a lipoma. Liposuction allows your surgeon to deflate the tumour. Once it becomes smaller, surgical instruments can be introduced through the liposuction incision without having to make it bigger. Any residual fat tissue is then removed.
How to prepare for your lipoma surgery
During Your First Consultation With Dr Kernohan
The diagnosis of lipoma is usually done based on its appearance and features alone. The physical examination performed by Dr Kernohan is usually sufficient and no further medical tests are needed.
Deep lying lipomas might be trickier to diagnose, so radiological imaging (MRI or CT scan) might be ordered for this purpose.
Once a diagnosis is made, you and Dr Kernohan will discuss the treatment options, and whether lipoma liposuction or excision surgery is a better choice for you.
Day of Lipoma surgery
Lipoma removal procedure is usually a one-day procedure, meaning that you can usually go home on the same day after your procedure.
In some cases, if the lipoma is in a sensitive location, you might be kept overnight for monitoring. Most patients, though, go home a few hours after their surgery.
Dr Kernohan will let you know if you need to stop any blood-thinning medications before your surgery. You should also stay without eating or drinking the night before your procedure.
After your lipoma excision surgery, a friend or a family member should be around to drive you home, as you might be still sedated and not cleared for driving.
Recovery After Lipoma Surgery
The full recovery and wound healing after lipoma excision surgery takes around 3-4 weeks. However, this depends on the size and location of the lipoma.
Deep lying lipomas, larger lipomas, and lipomas in annoying locations (like the inner thigh or hand) might take longer to heal properly.
You can usually go to work 1-2 days after the surgical removal of lipoma. Try to avoid sports for the first 2 weeks after lipoma surgery to prevent trauma and problems with healing (especially if your lipoma is located in your legs or foot).
What are the risks and potential complications of lipoma removal surgery?
There are some complications and side effects that can occur after lipoma surgery:
- Wound dehiscence: On rare occasions, the sutures might break and the wound might open. This is more prone to happen if the lipoma was large and has left a large residual gap after removal
- Wound infection: Bacterial infections can occur after any surgery, and are usually treated with antibiotics. Signs of surgery include redness, pain, swelling, and pus drainage
- Scarring: Depending on the size of your lipoma, a visible scar might form after surgery
- Seroma and Haematoma: These mean respectively fluid collection and blood collection inside the lipoma cavity. Seromas and hematomas are not uncommon after lipoma excision and are usually treated by surgical drainage
In any case, lipoma surgery is still one of the safest procedures and does not entail any serious complications.
Visit the risks and complications of surgery page for more information.
How much is Lipoma Removal Surgery by Dr Kernohan?
Every lipoma patient is unique and will require different treatment and procedure.
To get an estimated quote for your particular surgery please contact Dr Kernohan’s team on 1300 39 38 99 or flll in the contact form. Please visit Dr Kernohan’s Surgery pricing page for more information.
How painful is lipoma surgery?
- Lipoma surgery is not very painful. During your lipoma excision procedure, you will not feel any pain, since you will be under anaesthesia. Any mild pain can be managed with analgesics.
How long does lipoma surgery take?
- This depends on the size and location of your lipoma. Small lipomas located in accessible locations (like the forearm) might need as little as 20 minutes to remove. Larger lipomas and deep-seated lipomas can need 2 hours or more to remove, as your surgeon will have to remove extensive tissue and reconstruct the area.
How long does it take to recover from lipoma removal?
- Recovery after lipoma excision is usually fast. You can get back to work within 1-3 days. Surgery for larger lipomas and lipomas located in mobile areas (like the foot) might require a longer home stay. In general, the wound should heal in 3-4 weeks.
Do lipomas grow back after removal?
- Lipomas have a recurrence rate of 1-2% after surgical removal.
Can a lipoma become cancerous?
- Lipomas can in extremely rare cases harbor cancer cells and turn into cancer – usually called liposarcoma. A growing skin lump should not be ignored and needs medical evaluation as soon as possible.
What size lipoma should be removed?
- There is no specific size threshold for lipomas to be removed. If a lipoma is annoying you and causing you pain and discomfort or cosmetic concerns, then it can be removed.
What is inside a lipoma?
- Lipomas are made of fat cells (adipose tissue). Sometimes, blood vessels and fibrous tissue can also run inside lipomas.
Do they put you to sleep for lipoma removal?
- This depends on the size and location of your lipoma. Larger lipomas located in hardly accessible areas usually require general anaesthesia (you will be put to sleep).
What kind of surgeon removes a lipoma?
- A plastic surgeon is the best type of surgeon to remove a lipoma. As opposed to other surgeons, a plastic surgeon masters specific cosmetic techniques that allows them to leave patients with the best cosmetic result possible.
Can a lipoma pop?
- No, a lipoma cannot pop on its own. It is made of fatty tissue that is adhesive to itself and the surrounding tissue. It will grow, but will not pop. You cannot pop the lipoma yourself at home either.
Further Reading about Lipoma Surgery
- 31345 | Medicare Benefits Schedule
- Combined Liposuction and Excision of Lipomas: Long-Term Evaluation of a Large Sample of Patients
- Liposuction Assisted Lipoma Removal – Option or Alternative?
- Lipoma Pathology
- Lipoma excision
- Surgical management of lipomas: Proposal of the Z-incision design and surgical algorithm based on tumor size
- Novel method of minimally invasive removal of large lipoma after laser lipolysis with 980 nm diode laser