Lipoma removal: types and methods of operations, rehabilitation

Surgeon

Bohyan

Tigran Surenovich

Experience 36 years

Surgeon of the highest category, Doctor of Medical Sciences, member of the International Association of Surgeons, Gastroenterologists and Oncologists

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Lipoma (fat) is a benign formation in the form of small nodules, the appearance of which is associated with the accumulation and compaction of excess adipose tissue. The size of the lipoma may increase or remain stable. When exposed to unfavorable factors, pockets of pathogenic microflora can form inside the wen, which makes it a source of other serious diseases of internal organs. The unaesthetic appearance of formations protruding on the surface of the skin is also important. Therefore, in most cases, a decision is made to remove the tumor and its subsequent histological examination to clarify the nature of the wen - benign or malignant.

The area of localization of lipoma is the back, chest, face, limbs, mammary glands, structure of internal organs. The formation can be detected accidentally during diagnostic procedures or during palpation. The edges of the lipoma are dense and clear, the formation is mobile, and its palpation is painless. It is more difficult to detect a lipoma in the tissues of internal organs. However, it is precisely such cases that are recognized as the most dangerous, threatening disruptions in the functioning of the affected tissue area.

Services and prices

Removal of lipoma more than 3 cm

7000 ₽

Removal of lipoma up to 3 cm

4000 ₽

Lipoma is the most common soft tissue tumor and consists of fat cells surrounded by a thin fibrous capsule. Popularly, such a neoplasm is called a wen.

Often, a person who is attentive to his body may stumble upon such a subcutaneous formation. Such a finding can cause, at a minimum, caution, and sometimes fear of the oncological process. The unknown is always scary. If you have any concerns, you should consult your doctor. In most cases, subcutaneous neoplasms in soft tissues are benign and do not pose a threat to the owner of the wen. However, lipomas still require the supervision of a specialist who must recognize a malignant process, if one occurs.

Peculiar red flags, signs that make you wary, are rapid tumor growth, pain, and the presence of two or more similar formations on the body.

By external signs, lipoma is little distinguishable from liposarcoma, hygroma, subcutaneous cyst, hematoma, parasitic invasion, inflammation or consequences of injury. Therefore, it is important that any neoplasms be examined by a doctor.

First of all, the question of the malignancy of the tumor is decided at the appointment. Liposarcoma occurs more often in middle-aged and elderly people. This is an aggressive and fast-growing tumor that can put pressure on surrounding organs and tissues and cause pain. Situations when an existing lipoma degenerates into a malignant tumor rarely occur. However, the oncological process requires a radically different approach to diagnosis and treatment, so it is important to diagnose it as early as possible.

Lipomas may have a hereditary predisposition. This fact, combined with the spread of wen to other parts of the body, makes the doctor suspect lipomatosis. Lipomatosis accompanies a number of hereditary syndromes such as Madelung's disease and Dercum's syndrome. Diseases with a family history require a special approach to therapy.

Primary sources of lipoma development

The appearance of wen is associated with various pathologies, sometimes they arise as an independent pathology. Provoking factors for the appearance of lipoma are presented:

heredity - if the parents have the disease, the probability of a neoplasm occurring is 75%;
disorders of embryonic development - tumors arise against the background of dystopia of embryonic lipid cells;
individual diseases - Cowden, Madelung, Dercum;
endocrine disruptions – with hypofunction of the pituitary gland, pancreas, thyroid gland, altered estrogen levels, malignant neoplasms of the upper respiratory tract;
sedentary lifestyle - congestion provokes blockage of glands and fat deposits;
dysfunction of tissue trophism - due to problems with the nutrition of nerve cells, free lipids begin to accumulate next to them;
injuries - when local metabolism is disrupted due to damage;
with age - a slowdown in metabolic processes and a decrease in protective mechanisms after 40 years becomes a source of wen.

The development of lipoma is influenced by bad habits and an incorrectly selected diet. Also, pathology is formed due to diseases of the digestive organs, genitourinary tract, liver, and hormonal imbalance.

Reasons for appearance

There are many factors that influence the formation of lipomas. Among the reasons are hereditary predisposition, impaired metabolism of fatty acids in the body, liver disease, pancreatic disease, non-compliance or violation of hygiene rules.

For a long time it was believed that soft tissue injury predisposes to the development of lipomas, but this fact was subsequently refuted in research. Thus, doctors agree that one reason that would explain all the processes has not yet been found. However, predisposition to gastrointestinal lipomas has a proven connection with a gene mutation on chromosome 12. In other cases, the reasons remain unknown.

Symptoms and classification

Lipomas are distinguished by anatomical location into lipomas of the head, face and neck, lipomas of the trunk, extremities, chest (mediastinum), mammary gland, gastrointestinal tract, internal organs, retroperitoneal tissue, spermatic cord. There are also rare localizations in the myocardium, lungs, and meninges.

Another classification of adipose tissue tumors involves a clinical division:

Lipoma surrounding nerve structures is called perineural . Due to compression of the nerves it can cause severe pain. Removal of perineural lipomas differs from subcutaneous lipomas and requires a highly qualified surgeon;
A tumor growing in the spinal canal (usually in the lumbar region) is called lumbosacral lipoma; Mostly occurs in children and is combined with underdevelopment of spinal structures;
Lipoma of the joint and its structures (synovium, vagina, tendons);
Intermuscular lipomas are formed from areas of adipose tissue between muscle fibers;
Angiomyolipoma is a tumor of fatty and muscle tissue, which in most cases grows in the kidneys and pancreas. Middle-aged and mature men are more predisposed to its formation;
Subcutaneous lipoma is a formation of varying sizes in the subcutaneous fat tissue. In everyday life it is usually called wen.

Lipomas usually occur alone. However, some patients discover several tumors at once. Such cases are most often associated with hereditary diseases and require careful study by specialists. The most common places for lipomas to form are the neck, back and limbs.

A subcutaneous lipoma is a mobile, elastic seal in the form of a lump or ball, which does not cause pain when pressed. A neoplasm can cause pain if it grows beyond its capsule into healthy tissue or due to compression of adjacent nerves.

For example, a wen located on the head can cause headaches, and the same formation on the neck can cause hoarseness and difficulty swallowing.

Gastrointestinal lipomas differ from their subcutaneous counterparts. Small formations in the intestine do not cause symptoms and are often discovered incidentally during an instrumental examination of the gastrointestinal tract. However, if it increases in size, this happens when the tumor reaches 2 or more centimeters in diameter, the lipoma can block part of the intestinal lumen and cause intestinal obstruction, intussusception, stool problems, abdominal pain and even bleeding.

By structure

Lipomas according to these characteristics are divided into:

Classic (there is only fatty tissue inside);
Angiolipomas (have vessels inside);
Hibernomas (in the fiber there are formations similar to the formations of hibernating animals);
Myelolipomas (hematopoietic and adipose tissue are located together);
Myxolipomas (contain mucous tissue elements inside);
Myolipomas (muscle fibers are found together with fatty tissue);
Fibrolipomas (there is connective and fatty tissue inside).

Treatment methods

The treatment method is selected based on the location of the tumor, size and medical history of the patient. First of all, the doctor must make sure that the patient’s neoplasm is benign. To do this, the doctor carefully examines the patient, collects anamnesis and, if necessary, refers him to the necessary tests. For the differential diagnosis of lipomas, ultrasound examination of soft tissues, computed tomography, magnetic resonance imaging are used and, if a malignant tumor is suspected, a tumor biopsy is taken.

The most common type of tumor from adipose tissue is a subcutaneous lipoma, which does not cause dysfunction of organs, systems and does not threaten the patient’s life, and removal is performed only for cosmetic purposes.

Also, indications for surgical treatment of lipoma are large tumor sizes, 5 cm or more, and the presence of symptoms caused by the tumor.

There is no effective conservative treatment for lipomas. It is also worth noting that traditional methods such as heating and applying ice do not affect tumors from adipose tissue. However, they can cause serious complications if the neoplasm is of a different nature. For example, when atheroma is heated (atheroma is an accumulation of sebaceous secretion that clogs the duct of the sebaceous gland and causes inflammation), inflammation may spread and infect healthy tissues that are nearby.

Among the surgical methods for treating lipomas are:

lipoma excision
liposuction
laser removal
endoscopic method (for gastrointestinal lipomas)

Diagnosis and treatment of lipoma at the JSC Meditsina clinic in Moscow

The clinic of JSC "Medicine" in the Central Administrative District of Moscow is ready to offer professional assistance to patients with suspected single or multiple cases of lipoma development. The center’s specialists have high-quality equipment and extensive practical experience in using various methods of removing a tumor focus. Each patient is guaranteed attentive attention, referral to a full course of examinations and an individual approach to developing lipoma treatment tactics. Appointments are available on the clinic’s website and by calling the numbers provided.

Advantages and disadvantages of various methods

Lipoma excision.

Excision of a lipoma is the simplest and most affordable way to remove a wen. The operation is performed under local anesthesia. The surgeon injects the lipoma with an anesthetic and removes the tumor along with the capsule through an incision in the skin. Removal of the fibrous capsule is an undeniable advantage of this method. This prevents the re-formation of lipoma in the old place, which means it reduces the risk of relapse to a minimum. This method also allows one to examine the histological structure of the tumor. In general, the operation lasts no more than half an hour.

Liposuction.

Liposuction allows the tumor to be removed through a small hole. A special device is inserted into the cavity of the wen, which destroys the lipoma. Many doctors and patients love this method for its minimal invasiveness and good cosmetic results. However, the disadvantage is the inability to remove the fibrous capsule of the wen, which creates the possibility of future relapse of the tumor.

Laser removal.

Laser techniques are used to eliminate tumors larger than 3 cm. The method is gentle, carries minimal risks of bleeding and infection, and does not leave wounds or scars.

Atheroma

The origin of atheroma is fundamentally different from lipomas. Atheroma develops from the sebaceous glands of the skin. For various reasons, the gland duct becomes clogged, secretion accumulates in the gland, which gradually begins to increase in size. Atheroma is defined as a small (from 0.5 to 2 - 3 cm) formation, which always rises somewhat above the skin and is always fused to it (i.e. the skin above the atheroma does not move), and can grow slowly. Atheroma always has a capsule and contains atheromatous masses resembling crushed lard.

Because The atheroma is connected to the external environment by a duct; there is always a threat that it will become infected through the duct and suppuration will occur. In this situation, moderate pain appears in the area of the previously “quiet” atheroma, the formation quickly (over several days) increases in size, redness appears around it, and body temperature may rise. Suppuration of atheroma requires urgent surgery.

Preparation for the procedure

In case of subcutaneous lipoma removal, no special preparation is required. The mini-surgery is performed on an outpatient basis, meaning it does not require hospitalization. The surgeon performs all necessary manipulations under local anesthesia. Thus, the procedure is painless for the patient.

Giant subcutaneous lipomas, as well as neoplasms of the intestines, internal organs, and peritoneum require more serious and thorough preparation. Operations of this type are carried out with hospitalization of the patient. Before the intervention, samples are taken and, if necessary, additional studies are done. Operations performed under general anesthesia require restriction of water and food on the eve of the operation.