What is a lipoma?

A lipoma is a non-cancerous lump of fat that forms a nodule under the skin. They are extremely common and may be single or multiple. They tend to grow larger over time. They may occur anywhere on the body, but are most common on the back. They are soft, mobile lumps and are usually painless. Lipomas of the skin are not thought to ever become cancerous. There is a rare type of cancer of the fat (liposarcoma). It is not known to arise from a benign lipoma, but it is important that the correct diagnosis is made prior to surgery. Lipomas are common in all ages, but tend to occur in the 40-60 year old age group.

How is a lipoma removed?

A small cut is made over the lump and it is easily removed. The skin is then sutured closed.

What type of anaesthetic will I have?

The type of anaesthetic used depends on the patient, the position of the lump and the size of the lump. Very small lipomas are easily removed with an injection of local anaesthetic to numb the skin. Large lipomas especially on the back are best removed under general anaesthesia (fully asleep).

When will I be discharged from hospital?

It is quite common to have a lipoma removed as day surgery. This means you will be able to leave after a recovery period. If you have had a general anaesthetic, you cannot drive, operate machinery or sign legal documents for 24 hours.

What are the complications of lipoma surgery?

Specific Risks:

  • Fluid collection under the wound: This is extremely common after lipoma surgery. When the lump is removed, there is a space left behind. This fills up with clear fluid. Sometimes this fluid will run out of the wound and you will need to wear a pad. Almost all patients would expect this to happen for a very large lipoma. Sometimes a small drain is left in the wound for a period of time to collect this fluid.
  • Infection: Wound infection is moderately common after lipoma surgery. (5%) of cases. If it occurs, it will require treatment with antibiotics.
  • Bleeding: occasionally there is bleeding under the skin that runs out of the wound. It occasionally requires a return to the operating theatre in the first few days after surgery. It is also quite common for there to be some bruising around the wound. This will get better.
  • Recurrence of the lipoma: Occasionally, a small piece of the tumour may be left behind and the lipoma will come back.
  • Nerve damage: as with any operation on the body, a nerve may be cut resulting in numbness under the wound.
  • Scarring: It is very common for wounds on the back to stretch over time because of the large amount of movement in the skin of this region. Certain people form ‘keloid’ scars – where too much scar forms.  This can be unattractive.

General Risks:

  • Death: approx. 1/40,000 risk for all patients having a general anaesthetic.
  • Blood vessel problems: heart attack, stroke. This is very rare.
  • Infections: Wound, pneumonia, urine, IV line related.
  • Clots in the legs that may travel to the lungs and be fatal.

What to expect immediately after surgery

Pain Relief

Every effort will be made to minimize the discomfort. Your surgeon and nurses will be monitoring your level of pain control frequently. If the wound is on your arm or leg – try and elevate that part. This reduces selling and pain. Local anaesthetic will be used in the wound and lasts for about 12 hours.

There are two major types of pain relievers after lipoma surgery.

Panadol

  • You will be amazed the power of regular Panadol. It will cut down the need for the very strong pain pills.
  • It does not cause constipation.
  • Do not take more than 8 tablets a day.

NSAIDs (Indocid, Brufen, Mobic)

  • Also excellent pain relievers. They do not cause constipation.
  • Must be used very cautiously in the elderly and those with kidney problems.
  • They may cause stomach ulcers.  If you experience any pain in the upper abdomen you must stop this medication immediately and seek advice.

Eating

It is usual to return to a normal diet within a day of general anaesthetic. There are no restrictions. It is very common to feel slightly nauseated for 12 hours following surgery.

After discharge

Your Incision

  • You can expect to have a waterproof dressing over your incision. You may remove this after five days or earlier if it is dirty or leaking. You will be able to shower with this dressing.
  • You may also have a pad on over this dressing. Your surgeon will tell you when to remove it.
  • You can peel the waterproof dressing off 5 days after the surgery. The wound should be healed by this time. It is common for the wounds to be bruised.
  • You may get the wounds wet after 5 days. Gently wash dried material around your incision and let water run over it. Pat it dry with a towel. Do not rub soap or moisturizer into your incision for at least 4 weeks or until it is fully healed. After this you may rub vitamin E cream along the wound.
  • You may or may not have stitches to remove. Your surgeon will let you know.
  • Your incision may be slightly red along the cut. This is normal.
  • It is normal to have a hard ridge of tissue under the wound. All patients get this and it disappears after about three months. It is normal to have a patch of numbness under the wound.
  • Over the next few months your incision will fade and become less prominent.

Activity

  • Do not drive, operate machinery or sign legal documents within 24 hours of an anaesthetic.
  • You may perform all other normal GENTLE activities.
  • Specific limitations will relate to the site of your wound.
  • You may gently swim after 2 weeks or when the wound is fully healed.
  • Heavy exercise may be started after 6 weeks – but use common sense and go slowly at first.
  • You may resume sexual activity when you feel ready unless your doctor has told you otherwise.

Costs to be incurred from this surgery

  • There will not be any out of pocket expenses for your surgery. Your health fund will be billed directly. Outpatient consultations are not covered by the health funds and there will be a small out of pocket fee. An account will be sent to your home address. You will get some of the money for outpatient consultations back from Medicare.
  • Your anaesthetist may also charge an out of pocket fee. You should ask them ahead of time about this cost. Ask who will be performing your anaesthetic and you can make enquiries with them as to any out of pocket expenses.
  • You will also have to pay any hospital excesses that your policy dictates.

What are the symptoms of a lipoma?

  • Generally, lipomas are completely painless. Occasionally, due to their position on the back, they may be uncomfortable. For many people, they are cosmetically unappealing.

What are the treatment options for a lipoma?

  • Lipomas are harmless, requiring no treatment if they are not causing any bother. They may surgically removed if required.