Everything you need to know about lipomas

A lipoma is a round, slow-growing benign tumor made of fat, and it usually forms between the skin and the underlying muscle. Less frequently, lipomas can be found within or underneath muscles. They can grow anywhere in the body where fat cells are present. They are most commonly found on the neck, shoulders, back, abdomen, arms and thighs. 

Lipomas are harmless because they are not cancer. They usually feel pretty soft to the touch and aren’t commonly tender. Generally, they are less than two inches in size, but they have the ability to grow. As they grow bigger, lipomas can sometimes become painful if they cause pressure on nearby nerves. 

How common are lipomas?

Lipomas are very common. We estimate that one in 1,000 people has a lipoma. This means that millions of people walk around with lipomas! 

Lipomas most commonly appear between the ages of 40 and 60, but they can develop at any age. Some people will have just one lipoma, but there are some rare conditions that cause multiple lipomas to form on the body. Many people have lipomas and don’t even notice them. 

Why do people get lipomas?

The cause of lipomas isn’t fully understood. We think that genetic factors play a role in their development because lipomas tend to run in families. Because of this, it is not possible to prevent them from forming.

How are lipomas diagnosed?

If you have a skin growth or a lump under your skin, you should first see your primary care doctor, especially if you notice any changes, such as a new pain or an increase in size. 

A thorough physical examination is usually sufficient to diagnose most lipomas. In some cases, your doctor may recommend a biopsy to confirm the diagnosis and make sure the lipoma isn’t cancerous. During a biopsy, your doctor will numb your skin and remove a little piece of tissue from the lipoma to be sent to a lab for analysis under a microscope. 

In cases where a physical examination is not sufficient to clarify the diagnosis of a lump, your doctor may order an imaging test, like an ultrasound, a computed tomography (CT) scan, or a magnetic resonance imaging (MRI) scan. These tests can be useful to identify the location of a lipoma, how deep it is, and if it presses against important structures like nerves.

What is the treatment of a lipoma?

Because most lipomas don’t cause health problems, they often don’t need treatment. However, lipomas do not naturally go away on their own. Home remedies found on the internet that claim to make lipomas disappear do not work! 

People will have lipomas surgically removed for cosmetic reasons, or if the lipoma is bothersome, continues to grow or becomes painful. 

If you want to have a lipoma removed, your primary care doctor will refer you to a plastic surgeon, a dermatologist or a general surgeon. The surgical procedure is usually done under local anesthesia by first numbing the skin and then by cutting out the lipoma. People can go home the same day. In cases where a lipoma is very large, or located deeper and close to the muscle, general anesthesia may be recommended for surgery. 

As an alternative to lipoma surgery, your surgeon may recommend liposuction to remove the lipoma. Liposuction uses a long thin cannula to remove the lipoma and tends to leave smaller scars. In my experience, it is useful in cases where there are multiple lipomas to help minimize the number of scars. 

Lipomas rarely grow back after they have been removed, but a new one may grow in a different spot on your body. Possible side effects of surgery are scarring and bruising.

It is important to get lumps evaluated by your primary care doctor to make sure they are not cancer. Call your doctor without delay if you notice any changes. Red flags that indicate that a lump could be cancer include a rapid growth over a few weeks and new, sudden pain.

Dr. Valerie Lemaine, M.D., M.P.H., is a top-ranked, board-certified plastic surgeon in private practice in Bloomington, MN. She received her M.D. from University of Montreal, Canada, and her M.P.H. from Columbia University, NY, USA. She also completed a reconstructive microsurgical fellowship at Memorial Sloan-Kettering Cancer Center in New York City. Dr. Lemaine then accepted a staff position at the prestigious Mayo Clinic (Rochester, MN) where she taught, practiced and published clinical research. In 2018, she transitioned to private practice and joined Plastic Surgery Consultants and Minnesota Oncology.