Microscopic pathology image showing a benign lipoma.
What are the other Names for the Procedure?
- Excision of Lipoma
- Lipoma Enucleation
- Lipoma Excision
What is Lipoma Removal surgical procedure?
- Lipoma Removal is a surgical procedure that involves the removal of a lipoma
- Lipoma is the most common type of soft tissue tumor. It is a benign tumor predominantly composed of body fat
What part of the Body does the Procedure involve?
- A Lipoma Removal involves the skin and underlying tissues, typically on the back, arms, and legs.
Why is the Lipoma Removal surgical procedure Performed?
A Lipoma Removal procedure is performed for the following reasons:
- Improve visual appearance (for cosmetic reasons)
- If the benign tumor is an “annoyance”
- In some cases, a diagnosis of lipoma needs to be confirmed. Removal of the lump (lipoma) for a definitive diagnosis is sometimes necessary, to ensure that the lump is not a type of tumor
- In rare cases, for the prevention of cancer, such as liposarcoma, which can arise with longstanding lipomas
What are some Alternative Choices for the Procedure?
Alternative choices to surgical removal of a lipoma include:
- Injection of steroids into the tumor
What are the Recent Advances in the Procedure?
Currently, there are no recent advances to the Lipoma Removal surgical procedure.
What is the Cost of performing the Lipoma Removal surgical procedure?
The cost of Lipoma Removal surgical procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.
In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.
When do you need a Second Opinion, prior to the Procedure?
- It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Lipoma Removal surgical procedure and what needs to be done
- If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
- Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently
What are some Helpful Resources?
Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006
http://www.aafp.org/afp/2002/0301/p901.html#sec-1 (accessed on 07/30/2014)
Prior to Lipoma Removal surgical procedure:
How is the Lipoma Removal surgical procedure Performed?
- The Lipoma Removal procedure is carried out under local anesthesia
- Smaller lipomas are removed by enucleation, while larger lipomas are excised
- In enucleation, the surgeon makes a small incision on the skin overlying the lipoma. Using an instrument called a curette (shaped like a thin rod with a small scoop/gouge at the end); the surgeon separates the lipoma growth from the adjacent normal tissue and removes it completely. After this, a pressure dressing is applied over the small wound
- In order to remove larger lipomas, the surgeon makes a couple of incisions on the skin overlying the tumor. While applying pressure (a pull) to the flap of skin made by the incisions, the surgeon cuts out the lipoma from the adjacent tissue carefully. Once the tumor has been removed, the resulting tissue space is closed using absorbable suture material (these sutures need not be removed at a later date) and the skin is closed using non-absorbable sutures
Where is the Procedure Performed?
A Lipoma Removal procedure is usually performed in an out-patient surgery center facility or a physician’s clinic/office. Normally, the individual can go home once the procedure is completed.
Who Performs the Procedure?
The Lipoma Removal procedure is performed by any of these medical personnel, with assistance from an anesthesiologist:
- Family doctor
- General surgeon
- Plastic surgeon
- Reconstructive surgeon
How long will the Procedure take?
The Lipoma Removal procedure is usually completed in a few minutes time.
What do you need to tell your Physician before the Procedure?
It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the lipoma removal surgical procedure and helps avoid unnecessary complications.
- Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
- If you are allergic to any specific medication or food items
- If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
- If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
- If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
- If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
- If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
- A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.
What Preparations are needed, prior to the Procedure?
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
- Blood tests may be performed to determine, if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
- Do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
- Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
What is the Consent Process before the Procedure?
A physician will request your consent for Lipoma Removal procedure using an Informed Consent Form.
Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.
You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.
What Tests are needed, before the Lipoma Removal surgical procedure?
Before a Lipoma Removal procedure, the patient has to undergo certain tests, such as:
- Routine blood and urine analysis
- Imaging modality, if the physician deems it necessary
What are some Questions for your Physician?
Some of the basic questions that you might ask your physician are as follows:
- What is a Lipoma Removal surgical procedure?
- Why is this procedure necessary? How will it help?
- How soon should I get it done? Is it an emergency?
- Who are the medical personnel involved in this procedure?
- Where is the procedure performed?
- What are the risks while performing the procedure?
- What are the complications that might take place, during recovery?
- How long will it take to recover? When can I resume normal work?
- How many such procedures have you (the physician) performed?
- Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
- What are the costs involved?
During the Lipoma Removal surgical procedure:
What kind of Anesthesia is given, during the Procedure?
Commonly, local anesthesia by injection is administered, prior to the Lipoma Removal procedure.
How much Blood will you lose, during the Procedure?
Usually, there is a very negligible blood loss during the Removal of Lipoma.
What are the possible Risks and Complications during the Lipoma Removal surgical procedure?
There are general factors that increase the risk of getting complications during surgery and they include:
- Obesity: Generally greater the degree of obesity, greater is the surgical risk
- Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
- Advancing age
- Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
- Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
- Poorly functioning liver, as evidenced by increased blood liver function tests
- Hypertension (increased blood pressure), especially if it is poorly controlled
- Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
- Poor lung function, as evidenced by abnormal lung function tests
- History of bleeding disorders
- Longstanding illness, such as autoimmune disorders, chronic infections
- Poor immune system due to a variety of causes
- The possible risks or complications that may arise during the Lipoma Removal surgery are:
- Excessive bleeding
- Infection surrounding the surgical wound
What Post-Operative Care is needed at the Healthcare Facility after the Lipoma Removal surgical procedure?
At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise.
After the Lipoma Removal surgical procedure:
What are the possible Risks and Complications after the Lipoma Removal surgical procedure?
The possible risks and complications that may arise after Removal of Lipoma procedure are:
- Excessive bleeding
- Infection in the surgical wound
- Fluid accumulation(seroma) or blood accumulation (hematoma) under the skin
What is the Prognosis after the Surgery?
A complete recovery from Lipoma Removal procedure is normally achieved. The prognosis is usually excellent, without any serious complications being noted.
When do you need to call your Physician?
Do contact your physician if you notice any of the following symptoms:
- Worsening pain and swelling within the surgical wound
- Bleeding or fluid drainage around the surgical wound
- Signs of an infection
- Muscle aches
- Fever, feeling sick
- Complications associated with prescription medications used in treatment
What Post-Operative Care is needed at Home after the Lipoma Removal surgical procedure?
At home, the following post-operative care is recommended, after a Lipoma Removal procedure:
- It may be required to use sanitary napkins (for bleeding) for about a week or more
- Use a heat pad or warm compress to relieve pain, due to the incision
- Resume showering and keep the wound clean and dry. Gently wash the surgical wound with mild or unscented soap
- Replace the dressings on the surgical wound after showering
- Apply nonprescription antibiotic ointment to treat discharge from the surgical wound
- Complete the course of prescribed medication as advised by your physician
- Avoid taking nonprescription medications, such as aspirin. However, individuals may take acetaminophen to relieve pain, if required (per physician’s advice)
How long does it normally take to fully recover, from the Procedure?
- Individuals can resume their normal activities within a few days’ time, depending on the size and location of the lipoma that was removed
- If skin sutures were placed, they have to be removed in about 1-2 weeks’ time
What happens to tissue (if any), taken out during the Procedure?
The tissue is taken for further examination and later disposed as per the standard medical procedure.
When should you expect results from the pathologist regarding tissue taken out, during the Procedure?
- The tissue removed is processed in the laboratory under a pathologist's supervision
- Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
- Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time
Who will you receive a Bill from, after the Lipoma Removal surgical procedure?
It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.
Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:
- The outpatient facility or a physician’s clinic/office
- A family doctor, general surgeon, dermatologist, plastic surgeon, or a reconstructive surgeon
- An anesthesiologist (if anesthesia was administered)
- A pathologist (if the tissue was sent for analysis)
The patient is advised to inquire and confirm the type of billing, before the Lipoma Removal surgical procedure is performed.
Thanks and Gratitude:
We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.
Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA