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Lipomas (Fatty lumps)

Finding a new lump anywhere on the body can be an unsettling discovery.  Rest assured that the vast majority of these lumps are non-cancerous.  The most common lumps that are found are fatty lumps that are called lipomas. 

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  • Location: Anywhere on the body.

  • Characteristics: Soft, but feels firmer than the surrounding area fat. The skin over the lipoma is normal and not inflamed.

  • Pain: Usually not painful, but can be sensitive to touch if next to a nerve.

  • Size: Ranges quite a bit, but the ones that can be removed in the office are usually up to about an inch in diameter. 

  • Why do they form?: Any cell in our body is capable of dividing, even non-cancerous ones.  In the case of benign lipomas, fat cells have divided to form a lump and by definition are benign tumors, but are not cancerous in that they are unable to invade the adjacent tissue, and they have typical microscopic characteristics.

  • Do I need to have my lipoma removed?:  Small lipomas do not necessarily require removal and can be watched.  You may consider removal in these circumstances:

  1. Location where they are bothersome (eg like your forearm, where is rests on the table for writing or typing).

  2. Tenderness to touch possibly due to location next to a nerve.

  3. Increasing size.  Even when lipomas are increasing in size, the vast majority of lipomas still are benign, however less than 1% develop atypical microscopic changes which have the potential to progress to liposarcomas.  For this reason if a lipoma is rapidly increasing in size, removal is recommended to have it evaluated it by pathology.

  4. A definitive diagnosis is desired- Pathology evaluation can confirm it’s a benign lump. 

  • What are the risks of lipoma removal?: 

  1. Infection- There is small risk of infection with any procedure.

  2. Bleeding- We do not expect significant bleeding, but in rare instances, delayed skin edge bleeding can occur which usually responds to pressure application.

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Lipoma removal as an office procedure

Smaller lipomas, about an inch in diameter or less can

be removed in a dedicated procedure room at the office.  The process is similar in intensity to having a dental procedure.

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What to expect the day of procedure:

  •  Pre-procedural prep: none.

  • Sterile skin prep is applied to the area of the lump.

  • Local anesthetic is injected to the skin over and around the lump.  This feels like a brief bee-sting, and is effective immediately.

  • The lump is removed via a small skin incision correlating to the size of the lump.  

  • The skin incision is closed with buried, dissolvable sutures, and no sutures will need to be removed later.

  • Re-enforced tapes called “Steri-Strips” will be placed over the skin, then a clear waterproof dressing. 

  • Finally, we decide whether the lump should be sent for pathology evaluation under the microscope. 

  • Done!

Post-procedural care:

  • You can wash or shower at anytime.

  • Remove the clear waterproof dressing in 48 hours and allow the Steri-strips to fall off on their own.  The Steri-strips can be removed if they are still on the skin after 7 days.

  • Most people just require over the counter Tylenol or Ibuprofen/Advil/Motrin for any discomfort after the procedure.

  • Schedule a telemedicine or in-office post- procedural visit for 1-2 weeks.