Lipoma Treatment

CT scan showing a forehead lipoma before plastic surgery by Dr. Chaboki. This lipoma was adherent to the bone and under the forehead muscle and created a visible lump on the patient’s face.

Washington DC cosmetic surgery patients want a nip and tuck with lip injections or a facelift. Some, however, come to a plastic surgeon’s office to treat a visible lump on the body, which may be a lipoma.

Lipomas are a relatively common cause of lumps throughout the body. Fortunately, most of these lumps are benign (noncancerous) lipomas.

What is a lipoma?

Lipomas are soft tissue tumors or growths made mostly of fat tissue. Lipomas can range in size from a small nodule to several centimeters in size. Lipomas can occur anywhere there is fat, but more likely to develop in areas such as the neck, trunk, shoulders, and armpits. In the face, many lipomas are found in the forehead.

Lipomas are generally painless and don’t fluctuate in size. Lipomas are slow growing tumors that are normally benign. Extremely rare cases can be malignant (cancerous), known as liposarcomas. Patients often come to a plastic surgeon once the lipomas are a certain size since they don’t like the appearance of the lipoma.

Doctors don’t know why lipomas start in the first place and many have a single lipoma. Prior tissue injuries may possibly encourage lipoma formation. Certain genetics, however, can predispose to several lipomas in the same patient.

How are lipomas diagnosed?

All physicians start with a detailed history and physical exam. Your plastic surgeon will ask several questions about the lump itself, in addition to your past medical history. On examination, lipomas are typically soft and nontender. Given the specific body location, many lipomas are mobile, but if adherent to bone then the lipomas can be more fixed in place (example photograph above).

A clinical diagnosis of a lipoma can be made in the office. However, MRI, CT scan, and/or ultrasound of the body area can help differentiate a lipoma from other body tumors. Tissue biopsy with laboratory examination is the only reliable method to diagnose a lipoma.

How are lipomas treated?

Lipomas should first be evaluated by a physician, which may include radiology testing to provide some reassurance that the lump is more likely benign and not a cancer.

The prognosis or outlook for people with lipomas is typically very good. Since lipomas are generally harmless and may not affect a person’s quality of life, patients may choose to observe a lipoma. Patients are more likely to visit a plastic surgeon when the lipoma affects their appearance.

Lipoma surgery

Surgical excision is the primary method of treating lipomas. Surgery is generally a simple, outpatient or office procedure. A small incision is made in the skin over the lipoma, and the lipoma is gently freed from surrounding tissue and removed.

Relatively small lipomas can be removed via awake, local anesthesia. Dr. Chaboki has removed forehead and scalp masses frequently via this method. Largery lipomas may require general anesthesia for adequate lipoma surgery.

Liposuction

Liposuction is a less invasive option to treat certain lipomas and may be combined with body contouring procedures as appropriate for certain plastic surgery patients. There is less external skin scar. However, the disadvantages of liposuction include increased risk of lipoma regrowth or recurrence, as the lipoma lump is not removed, but rather reduced in size. In addition, liposuction does not allow tissue testing as compared to surgical excision to confirm benign diagnosis. Read more about liposuction.

Steroid injection

Steroid injection is an office procedure that may reduce the size of certain small lipomas, so they may not be as visible. Steroid injection does not remove lipomas, but rather shrinks it to some degree. Read more about steroid injections for scars.

Kybella®

Kybella is new drug from the makers of Botox® that reduce neck fat to treat a double chin. It has not been FDA approved for the treatment of lipomas. However, some patients are asking about this option. Read more about Kybella to treat a double chin.