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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.


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.

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