What is Lipoma Excision?
Lipomas are the adipose tumors that usually occur in the
subcutaneous tissues of the head, neck, shoulders and back.
These slow-growing, almost always benign, tumors typically
present as non-painful, round, mobile masses with a
characteristic soft, doughy feel. Lipomas can rarely be
linked with syndromes such as hereditary multiple
lipomatosis, adiposis dolorosa, Gardner's syndrome and
Madelung's disease.
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Effects of Lipoma Excision
The outcome and prognosis of lipoma excision are excellent for benign
lipomas. Although recurrence is rare, it may still happen if
excision is incomplete.
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Candidates for Lipoma Excision
Lipomas are not selective of any age group but these
usually first appear between 40 and 60 years of age. It is
not generally necessary to treat a lipoma unless it is in a
bothersome location, is painful or is growing, your doctor
possibly will suggest that it be removed.
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Your
Consultation
Prior to
surgery, it is often helpful to draw an outline of the
lipoma and a planned skin excision with a marker on the skin
surface. The outline of the tumor often facilitates to
define margins, which can be hidden after administration of
the anesthetic. Excision of some skin helps to get rid of
redundancy at closure.
The skin
is then cleansed with povidone iodine or chlorhexidine
solution, making sure to prevent wiping away the skin
markings. The area is covered with sterile towels. Local
anesthesia is administered with 1 or 2 percent lidocaine
with epinephrine, more often than not as a field block.
Putting the anesthetic in the subcutaneous area surrounding
the operative field creates a field block.
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The Lipoma Excision
Procedure
There are multiple surgical techniques that can treat
lipomas. The simple
surgical excision involves marking the palpable borders on
the skin before infiltrating with anesthesia. Then the skin
down to the lipoma capsule will be incised and dissected to
free the mass from the surrounding tissue. After obtaining
hemostasis, the dead space will be closed using buried
absorbable sutures. The excess skin will then be removed,
the wound closed, and a pressure dressing will be applied
for 24 hours to prevent hematoma or seroma formation.
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Recovery
Before
putting new bandages, it is important to apply a
non-prescription antibiotic ointment to the wound first. You
may use non-prescription drugs (such as acetaminophen) for
minor pain.
Anticipate complete healing without complications and allow
approximately 3 weeks for recovery from surgery.
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Risks
Infection and calcification (hardening) can happen in a
stable pressure area or movement area. It rarely causes a
fatal condition by complicating the functioning of the
lungs.
Lipomas can arise in the breast, liver, digestive organs,
oesophagus, etc., developing symptoms according to the
situation. Adiposis dolorosa or dercum’s disease is an
extraordinary condition characterized by multiple painful
lipomas. Lipomas may rarely go through sarcomatous changes
to cause liposarcoma.
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Frequently Asked
Questions
Q:
What are lipomas?
A:
Lipomas
are adipose tumors that generally occur in the subcutaneous
tissues. These are slow-growing and almost always benign.
The majority of lipomas are asymptomatic, can be diagnosed
with clinical examination and do not necessitate treatment.
These tumors may also be found in deeper tissues such as the
intermuscular septa, the abdominal organs, the oral cavity,
the internal auditory canal, the cerebellopontine angle and
the thorax.
Q:
What causes lipomas?
A:
Heredity
is not really a factor in the development of lipomas. A
number of doctors believe that a minor injury may provoke
their growth. There is also a weak correlation of lipoma
incidence in overweight patients, although not enough
studies could support this case.
Q: Where
do lipomas usually occur?
A:
Lipoma can take place anywhere in the body. The common sites
are fat depositing areas like nape of the neck, shoulder,
back, trunk, buttocks, hips, thighs, arms, forearms and
belly. Most of lipoma is subcutaneous, but it can also
happen in deeper tissues like subserous (liver, lungs,
heart, etc.), subsynovial (joints), submucous (oral,
oesophagus, etc), subperitoneal (inside abdomen),
intramuscular, etc.
Q:
What are the symptoms of lipomas?
A:
Lipomas are usually
small [0.4 in.(1 cm) to 1.2 in.(3 cm)] and felt just under
the skin; are movable and have a soft, rubbery consistency;
do not cause pain; and remain the same size over years or
grow very slowly. Oftentimes, the most bothersome symptom is
the location or increased size that makes the lipoma
noticeable by others.
Q: Is
it necessary to treat lipomas?
A:
Most of the time, treatment of a lipoma is not needed,
unless the tumor becomes painful or limits movement. A lot
of people have it removed for cosmetic reasons. On the other
hand, if the capsule of the lipoma is not entirely removed
during the surgery, it may grow back.
Q:
What are the treatment options for lipomas?
A:
A lipoma may be eradicated by simple excision, but
liposuction is another option that usually results in
less
scarring if the lipoma is soft and has a small
connective tissue component. However, liposuction has a
greater tendency to not remove the entire lipoma, which
often results in regrowth.
Q: Do
lipomas ever turn cancerous?
A:
The simple answer is no. One medical reference source states
"Lipomas may rarely undergo sarcomatous change (that is -
change into a type of cancer). However, the event has never
been convincingly documented." It is very rare if it does
happen.
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