What is a Lipoma?
A lipoma is a cluster of fat tissue that exists between the skin and the underlying muscle layer. It typically feels soft and rubbery to the touch, and is most often found in middle-aged adults. Usually slow-growing and benign, lipomas exist just underneath the surface of the skin and commonly occur in the neck, shoulders, arms, abdomen, back, and thighs. Lipomas generally have very little potential to become cancerous. Although lipomas can occur at any age, they are most likely to present themselves in adults between the ages of 40 and 60 years old. No proven connection exists between the development of lipomas and any particular occupation or exposure, although some medical professionals believe that lipomas are more likely to occur in inactive individuals. There is normally no need to treat a lipoma unless it begins to grow rapidly, or becomes painful, uncomfortably large, or, in some cases, cancerous. Surgical removal may be necessary in these instances.
Types of Lipomas
While all lipomas are composed of fat cells, the various types of lipomas are categorized based on the characterization of the specific fat cells. An atypical lipoma, for example, is characterized as a deeper growth with a larger number of cells while a pleomorphic lipoma consists of fat cells of varying shapes and sizes. One particular type of atypical lipoma, a spindle cell lipoma, is composed of fat cells that are shaped like rods. Angiolipoma is another, more rare type of lipoma made up of both fat and blood vessels growing underneath the skin.
The American College of Surgeons recognizes that while some subtypes of lipomas appear to have a genetic component, it is largely accepted that the cause of lipomas is not yet fully understood.
It is important to evaluate a suspected lipoma in order to differentiate it from a more harmful or potentially cancerous growth. A doctor, surgeon, or dermatologist may perform a physical examination of the mass. During the physical exam, the doctor will feel the growth, evaluate its size and consistency, and determine how easily the mass can be moved within the surface of the skin. Deeper lipomas tend to be less mobile and it often takes longer to identify lipomas that are in deeper tissue. The skin overlying the growth may also be examined to identify any inconsistencies.
Although lipomas can usually be diagnosed based on history and a physical exam, imaging tests may be useful to categorize the growth. Ultrasound technology can be used to confirm the aggressive or indolent nature of the growth. In addition, a CT scan can confirm the diagnosis of lipoma as it provides more detail than an x-ray. In some instances, a biopsy may be required to rule out more nefarious growths, and confirm the diagnosis of a lipoma. In this procedure, a small sample of the growth is taken and further examined under a microscope. Such a biopsy is rarely needed but also necessary when indicated.
The only treatment that will completely remove a lipoma is surgical removal. In this procedure, a local anesthetic is injected around the growth to numb the area. In some cases, large lipomas or those that are deeply embedded within the soft tissues of the body may require regional or general anesthesia. After the anesthesia is given, the doctor will make an incision on the surface of the skin and remove the growth from beneath. This procedure is associated with minor discomfort and usually involves a recovery time of approximately one week. Patients are normally able to drive themselves home after the procedure has been completed and are able to return to work between one and five days post-removal.
While lipomas typically do not grow back after excision, surgical removal may be again required to remove a lipoma that has recurred.
Patient cost for lipoma removal depends on a number of factors, including the location and size of the lipoma, whether or not multiple growths are present, and of course the patient’s individual health insurance coverage. While lipoma removal surgery performed for medical reasons is normally covered by insurance, removal surgery for cosmetic reasons tends not to be covered by medical insurance, although individual plans vary significantly. While it is sometimes not medically necessary for a lipoma to be surgically removed, RS Surgical recognizes that benign lipomas can still present discomfort for the patient. For cosmetic lipoma removal surgery that is not covered by insurance, RS Surgical will generally work with the patient and provide a discounted rate as applicable.