Lipomas

Lipomas

Are you looking lipoma removal in Auckland, or lipoma removal Christchurch?  Have you found a skin lump on your face, scalp, neck, or back perhaps? - This could possibly be a lipoma. Do not worry, you have come to the right place. A lipoma can be effectively removed by minor local surgical removal under local anaesthetic. Dr Beulink has been specialising in removing skin lumps, bumps, lipomas and sebaceous cysts for over 20 years with cosmetic outcomes second to nobody. So if you’re looking for lipoma NZ, or lump or lipoma removal NZ, get in touch with Dr Beulink today. Consultations for lipoma surgery at Auckland and Christchurch clinics with lipoma surgery being available in Auckland and Christchurch.
 

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A moderately large lipoma that presented as a lump (thought initially to be a cyst) in the relatively non-fatty area of high forehead. Lipomas are more commonly found in the trunk/torso or upper arm and leg areas but can in fact present almost anywhere.

A Lipoma will often appear as a mobile, nontender lump just under the skin. A lipoma can be soft or firm, evenly or oddly shaped, long, flat or round. Lipomas are very slow growing and by the time they are first noticed, they are usually around 1cm in diameter, but can grow to many centimeters in size over many years.

Lipomas are benign (non cancerous), and typical simple lipomas consist of a lump of fatty tissue. Less common variations may include other tissue types within the fat, such as fibrous, vascular or glandular tissue, and may account for why some can be firmer or tender. Unlike cysts, lipomas are not contained within a discrete sack, and thus have far less definition separating them from their surrounding tissue. This can make them significantly more difficult to remove than simple cysts.

Lipomas are relatively common (occur in 2% of the population, more common in males, rare in children), and usually occur in  the trunk/torso and upper legs and arm areas, but can occur anywhere there is fat (I have also seen and removed lipomas from the forehead and side of face and neck). In their early stages, lipomas can often be easily misdiagnosed  as sebaceous cysts. The longer a lipoma exists (and they tend to be very slow growing over many many years), the larger it tends to become, to the point where it simply starts to become visibly obvious or of a size that becomes bothersome. A small skin lump that rapidly increases in size and discomfort, is unlikely to be a lipoma (more likely to be an infected sebaceous cyst).
There are many other causes of lumps, some of which are not so benign. Luckily these tend to be rare, but for any lump, I suggest you obtain a medical opinion.

Surgical Removal of  Lipomas
Removal of a lipoma is typically a minor surgical procedure performed under local anaesthetic (however, I have removed a lipoma that was many years old and the size of a fist; in such a case it is obviously not quite so "minor"!). Unlike cysts however, lipomas have no encapsulation or sack so removing them in their entirety can be difficult and sometimes impossible. They can have very poorly defined edges, and often creep out in various directions into the surrounding tissues. There is sometimes a limit to how far one can chase these or be completly certain to have got everything. For most, the degree of certainty of complete removal can be close to 100%, and fortunately because lipomas tend to be very slow growing, for the rest the lump will reduce or disappear for many years before perhaps slowly growing back.

The key to successfully removing a lipoma with minimal scar and minimal chance of recurrence is five fold:
1) making the smallest single linear incision in the skin over the lipoma, as is possible (unlike the surgical removal of something like a mole or skin cancer where an elipse of skin includes cutting and removing skin around the mole, for lipoma removal no such skin needs to be removed). The length of incision will be somewhat proportional to the size of the lipoma and needs to be big enough to enable adequate extraction (the bigger the lipoma, the more chance of extensions and the more there will be to "chase", the longer the incision). However with skill and care, this cut can be kept to a minimum.
2) appropriate consideration to the placement and orientation of the surgical cut, will help reduce local stress on the healing wound.
3) clearly identifying and "chasing" the extensions of the lipoma to maximise complete extraction.
4) impeccable wound closure and suturing. Commonly used individual type surface stitches, give poor long term scar results, often looking like a scar line with halo or "eye-lash" effect either side of it. A hidden "underground" type single suture appropriately placed, will give a much better result.
5) taping the wound line for up to 12 weeks post surgery (not always practical or possible) will help prevent stretching or splaying of the scar.

Non-Surgical Removal of Lipomas
Sometimes it may not be feasible to surgically remove lipomas. This could be because of size, position or perhaps too many of them. Both options do not completely remove the lipoma, so in the long term the lipoma will almost certainly slowly reappear.

1) Local mini-liposuction. Ideally reserved for large, soft, superficial lipomas. Performed under local anaesthetic (typically tumescent style local anaesthetic). Usually a one off procedure to reduce or flatten the lipoma lump. Click here for more information on local tumescent liposuction.

2) Lipo-Dissolving injections. May be used to reduce the size of lipomas when multiple lipomas are present. Involves injection of fat dissolving solution directly into the lipomas. Success may be variable. Usually requires multiple treatments, each treatment usually 6 weeks apart. Click here for more information on Lipo-Disolve. 
 

Lipo-Dissolve injections may be a treatment for multiple Lipomas. After photo 8 weeks following injection treatment.