Common Lumps & Bumps – Lipomas
What are they?
Lipomas are soft, painless, flesh-colored lumps found on almost any part of the body. They are caused by collections of fatty cells in the subcutaneous layer of the skin. They may arise as single or multiple lesions.
While most lipomas are small (less than 5 cm), some may be very large. Extremely large lipomas may raise suspicion for mimics such as liposarcoma.
Lipomas can occur at any age,although they are most commonly observed in the middle years of life. Most lipomas are slow growing lesions with little change in size noted over the years . Lipomas tend to have a soft, rubbery feel and are usually mobile (i.e. move freely under the skin). While most do not cause issues, some lipomas may cause local irritation: e.g. the presence of a lipoma at a flexural region such as the folds of the arm or neck may cause frequent rubbing and subsequent irritation and discomfort .
Why do I get them?
No one quite knows why you get lipomas. There seems to be a genetic component to developing lipomas, meaning that you are more likely to have them if you have blood relations who do. Some lipomas may be aggravated by minor injuries too.
Less commonly, there are inherited conditions like familial lipoma syndrome, Gardner’s symdrome or Dercum’s disease that can cause large numbers of lipomas to develop in affected individuals.
Are they dangerous?
Lipomas are benign lesions. They are not cancerous or harmful to the individual. They may, however, cause localised irritation and discomfort, particularly when found in flexural regions or areas of the skin prone to frequent motion/rubbing.
Rarely, a cancerous lesion known as liposarcomas may resemble a lipoma. Unlike lipomas however, liposarcomas tend to grow rapidly, are fixed (don’t move easily under the skin), and are usually painful.
What should I do?
For the large part, lipomas can be left safely alone. However you should consult a doctor if you note any unusual activity in your lesion ( e.g. rapid growth, persistent pain, fixation of previously mobile lesion etc). If necessary, your doctor may recommend a biopsy of the lesion or imaging such as Magnetic Resonance Imaging (MRI) to rule out liposarcomas or other malignant lesions.
You may also wish to consult a doctor if you are keen for removal of the lipoma, either for cosmetic reasons or for relief of localised irritation.
How do I get rid of it?
Lipomas may be treated conservatively with steroid injections; however results are usually unsatisfactory. The best treatment approach is removal of the lump. While liposuction is possible, the far preferred technique is surgical excision. This can usually be done safely and quickly in the GP setting. Under local anaesthesia, the lesion can either be excised completely or removed in a segmental fashion. The incision wound is closed by suturing, with removal of the sutures done at a separate setting.
Even with complete excision of the lesion there may be a small chance of recurrence. However such recurrences generally tend to start small and progress very slowly so you may still benefit from removal.
Occasionally, very large lipomas or lipomas in certain regions such as the neck may need to be removed in an operative setting , often with general anaesthesia. In these circumstances, you may be referred to a surgeon to review and prepare for the surgical removal. Most lesions can still be done as a day surgery and you should be able to return to work soon after.
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