Lipoma Removal Treatment: Surgery, Procedure, and Pictures

Being an invasive procedure, it can usually take about 20 to 45 minutes, depending on the patient's health condition and the type and size of the lipoma. Most of the lipomas are removed under local anaesthesia (medication used to reduce the sensation in a specific part of the body) by a specialized team of anaesthetist, dermatologist, and other medical staff. The following steps are carried out during the lipoma removal surgery:

1. The surgical site will be exposed, and the rest of the body is covered with a sheet/blanket.
2. The treatment site will be cleaned with betadine solution.
3. The surgeon will draw an outline to mark the location of the lipoma.
4. Local anaesthesia is then administered with a 1 to 2 per cent lidocaine with epinephrine concentration. The affected skin is also cleaned with povidone, iodine, or chlorhexidine.

If the lipoma is very small:

1.  A 3 mm to 4 mm excision is made in the skin over the lipoma to place a curette inside the wound.
2. Using the curette, the surgeon will begin to free the lipoma from the tissue surrounding it and then enucleate it from the cut.
3. If the incision is very small, the surgeon will simply put a pressure dressing over the wound.

If the lipoma is large:

1. A larger incision (usually just a bit smaller than the lipoma) will be made that follows the skin tension line.
2. For the surgery, a haemostat or Allis clamp will be used to provide skin traction.
3. The surgeon will start to dissect the subcutaneous fat using a scalpel to reach the tumour underneath.
4. During the procedure, the surgeon avoids the nerves and blood vessels.
5. The surgeon will end the procedure by suturing and closing the incision.
6. The lipoma sample will be sent to a laboratory for biopsy.
7. After the procedure is done, the area will be covered with a waterproof dressing.
8. The patient will be asked to come back to OPD for dressing and suture removal after a week.

Prior to the lipoma removal surgery, the doctor/surgeon will discuss and prepare the patient for the surgery. These steps often involve:

Before Lipoma Removal Surgery

1. The treatment area will be cleaned with antibacterial soap.
2. The patient will be advised not to shave the treatment area.
3. The patient would need to stop taking ACE inhibitors and blood pressure medication on the day of the surgery.
4. The doctor will advise the patient to stop taking blood thinners, apart from aspirin, for some time.
5. While taking the instructions about the medications, the patient should make sure that he/she has discussed his/her full medical history, including any supplements or medications the patient takes.
6. The patient will be sedated for the surgery, so the patient has to fast for at least six hours before the surgery.
7. The patient must keep in mind that there may also be additional fees involved for overall medical care if additional tests (like CT scans, pathology reports, or blood tests) are involved.

On the day of Lipoma Removal Surgery

1. The patient will be asked to sign the consent form in the presence of his/her family.
2. Instructions to stop drinking or eating 6 hours before surgery, depending on the result of the pre-admission assessment will be given.
3. Mostly local anaesthesia, while in rare cases, general anaesthesia, will be administered before the surgery, depending on the size of the lipoma, so that the patient won’t feel any pain during the procedure.
4. Vitals will be monitored.
5. The patient will then be shifted to the operation theatre.

A patient who has undergone lipoma removal surgery can expect the following after the surgery:

The recovery process in the hospital

1. After the surgery is complete, the patient will be moved back to the hospital ward so that he/she can recover.
2. The dressing will be specific to the location of the procedure. If surgical glue is used, then there will be no dressing to remove.
3. If the doctor has applied bandages, they can be easily removed in 24 to 48 hours at home.
4. The doctor will advise the patient to stay with someone for the next 24 hours to ensure the patient arranges a ride home.
5. The doctor will discharge the patient once he/she is stabilized and also will provide instructions for home care and follow-ups.

Recovery process/expectation after hospital discharge

1. The doctor will also prescribe some medicines like Motrin, ibuprofen, or aleve in addition to the narcotic pain medication after the surgery.
2. The doctor will recommend the patient stay at home when he/she is discharged.
3. The patient must avoid fried foods, milk products, and citrus for around one day after surgery. The patient will be asked to eat fibre rich diet, fruits and vegetables.
4. The patient can shower within a day or two after the surgery, but the patient has to avoid the pool for around a week.

First follow-up appointment

1. The first follow-up will be scheduled within 7 to 10 days after surgery.
2. In case the patient is not facing any kind of discomfort, he/she can visit the doctor after two weeks and get the sutures removed. 
3. The doctor might also change the medication or advise the patient to continue with the previous medication for some more time, depending on the condition and recovery of the surgical area. 
4. The doctor will advise the patient for further timely follow-ups as well.

Lipoma removal surgery is often done for cosmetic reasons more than medical reasons, but the benefits of lipoma removal surgery are both cosmetic and medical. Below mentioned are some of the common benefits of lipoma removal surgery:

1. Removing a large lump from underneath the skin will make it aligned again.
2. Lipoma present in a prominent part of the body can affect the self-image and eventually, self-esteem. Lipoma excision can help boost confidence.
3. The lipoma removal surgery is done to relieve pain and improve the ability to perform daily life activities without any hassle.
4. If the lipoma is more than 5 cm and pressuring nerves and causing pain, it becomes necessary to remove it for a better quality of life.

Lipoma removal surgery is a relatively simple procedure, but it is a surgical procedure, and just like any other surgical procedure, lipoma removal surgery has certain risks and complications associated with it. These include:

1. Infection of the incision site
2. Cellulitis and Fascitis
3. Bruising
4. Bleeding
5. Accumulation of blood under the skin or hematoma productions
6. Nerve injury
7. Muscle injury
8. Injury to nearby vascular structures
9. Fat embolus
10. Excessive scarring
11. Permanent deformity due to scarring

When is consultation with the doctor needed?

The patient can visit the doctor if he/she is facing any kind of discomfort, such as:

1. If there is bleeding more than expected.
2. If an infection develops in the surgery area.
3. If a pocket of fluid or blood has formed under the skin.

If lipomas are not treated in time, they can be uncomfortable and may affect daily activities of an individual. Risks of delayed lipoma removal surgery may include:

1. Continuing growth in size and number
2. Obstruction and pressure on the surrounding nerves and blood vessels causing discomfort and pain
3. Bleeding
4. Inflammation/swelling
5. Infections
6. If lipomas are growing in joints, it can cause problems with movement
7. Conversion to cancer

The cost of lipoma removal surgery ranges from ₹20,000 to ₹1,00,000. The cost varies based on the following factors:

1. Number and size of lipomas
2. Location of lipoma (body part)
3. Technique and equipment used
4. Age of the patient.
5. Other medical conditions that the patient may have.
6. The type of hospital facility availed - individual room or shared.