Lipoma — Removal of a Benign Fatty Tumor in Belgrade

What is a lipoma?

A lipoma is a benign tumor made of mature fat cells, most often located in the subcutaneous tissue — the layer immediately beneath the skin. Under the fingers it feels like a soft, smooth and movable lump that shifts easily in relation to the surrounding tissue. Lipomas are painless in the vast majority of cases, grow slowly and can stay the same size for years, and most often appear on the back, shoulders, neck, arms, thighs and abdomen.

Although the word tumor sounds worrying, a lipoma is a benign change — meaning it does not metastasize and does not threaten health the way malignant tumors do. It forms when a group of fat cells multiplies and creates a clearly defined capsule, so the lipoma has its own membrane that separates it from the surrounding tissue. Thanks precisely to that capsule, a lipoma is removed surgically, precisely and in full.

The exact cause of lipoma formation is not fully known. It is known that there is a hereditary tendency — some people develop several lipomas, sometimes within the family (hereditary lipomatosis). Lipomas are most often discovered in middle age, equally in women and men, and as a rule have nothing to do with body weight or diet.

At Medical Time a lipoma is viewed as a change that should be accurately assessed before any decision. The goal is to confirm with certainty that it is a harmless formation, to assess whether removal is needed and, if it is, to carry it out in a way that is safe for the patient and leaves as little trace on the skin as possible.

When is lipoma removal indicated?

Many lipomas do not have to be removed and can simply be monitored. Still, there are clear situations in which surgical removal is recommended — either because of symptoms or because of the need to determine the nature of the change with certainty. The decision is always made by the surgeon after an examination, and if needed after an ultrasound.

The most common reasons a lipoma is removed are:

• the lipoma is growing or has already become large and visibly changes the appearance of the skin
• it causes pain, pressure or discomfort — especially if it is near a nerve or joint
• it gets in the way with movement, dressing, sitting or wearing clothes and a bag
• it sits in a visible spot (face, neck, arms) and is an aesthetic problem
• it changes appearance, grows rapidly or becomes hard and immobile — which requires a check
• there are several lipomas that merge with one another or recur
• the patient wishes the change to be removed and histologically confirmed for peace of mind and reassurance

How lipoma removal is performed

Lipoma removal is a routine surgical intervention most often carried out under local anesthesia, on an outpatient basis — meaning the patient goes home the same day. The goal of the procedure is to remove the lipoma in full, together with its capsule, because this achieves the best result and the lowest likelihood that the change will reappear in the same place.

A classic surgical excision means that the surgeon, after numbing the area with a local anesthetic, makes a small incision in the skin over the lipoma, carefully separates it from the surrounding tissue and removes it together with the capsule. The incision is then closed with sutures, as a rule so that the scar is as inconspicuous as possible and follows the natural lines of the skin. For smaller lipomas a very short incision is enough.

For certain smaller and softer lipomas a technique of removal through a small incision with squeezing out of the content is also possible, which further reduces the scar. Which technique is best depends on the size, depth and position of the lipoma, and the surgeon assesses this at the examination. Larger lipomas, as well as those lying deeper (for example beneath the muscle fascia), require a somewhat more extensive procedure and are sometimes done under short-term analgosedation.

In every case, the removed tissue is sent for histopathological (histological) analysis. This step is standard and serves to confirm with complete certainty that it is a benign lipoma and not some other type of change of fatty tissue.

Preparation for lipoma surgery

Preparation for lipoma removal is simple, especially when the procedure is done under local anesthesia. Everything begins with an examination by the surgeon, at which the lipoma is clinically assessed, measured and, if needed, an ultrasound of the soft tissues is performed to precisely determine the size and depth of the change.

For smaller procedures under local anesthesia no special preparation or prolonged fasting is usually needed. If analgosedation is planned (for larger or more deeply located lipomas), the rules apply as for any intervention under sedation — arrival on an empty stomach and arranged accompaniment for the return home.

What is important to inform the surgeon of before the procedure and what to keep in mind:

• all medications you take, especially blood thinners (anticoagulants and antiplatelet drugs)
• chronic illnesses (diabetes, heart disease), previous surgeries and a tendency to impaired healing
• allergies, especially to local anesthetics, medications and dressing materials
• bring earlier findings and an ultrasound for review, if you have them
• on the day of the procedure wear comfortable clothing that easily exposes the area being worked on
• if it is done under sedation, arrange accompaniment and do not drive a vehicle that day

The procedure, anesthesia and duration

On the day of the procedure the patient is placed on the table, and the area around the lipoma is disinfected and covered with sterile compresses. The surgeon then injects a local anesthetic, which fully numbs the area — during the lipoma removal the patient may feel a slight pressure or touch, but not pain. The entire course of the procedure takes place in sterile, controlled conditions of the operating room.

Once the anesthetic starts to work, the surgeon makes an incision, carefully frees the lipoma from the surrounding tissue and removes it in full together with the capsule. The wound is then rinsed, any small bleeding is stopped if needed, and the incision is closed with sutures. Finally a sterile dressing is placed. For larger lipomas a small drain is sometimes left temporarily to allow excess fluid to drain.

The procedure of removing a smaller lipoma most often takes between 20 and 45 minutes, while larger or more deeply located lipomas may require somewhat more time. With preparation, anesthesia and dressing, the total stay at the facility is usually under two hours, after which the patient in the vast majority of cases goes home the same day.

If the procedure is done under analgosedation, the team beside the surgeon also includes an anesthesiologist who monitors pulse, breathing and oxygen saturation throughout the procedure, so the procedure is then calm and completely safe for the patient.

Recovery after lipoma removal

Recovery after lipoma removal is, as a rule, quick and easy. Most patients resume their usual daily activities as early as the next day, with a few simple measures that help the wound heal well and the scar be as tidy as possible. Mild tenderness, tightness or a bruise around the wound are normal and subside within a few days.

The wound is kept clean and dry according to the instructions, and dressing changes are done as agreed with the surgeon. The sutures are most often removed after 7 to 14 days, depending on the size of the incision and the location where the lipoma was. Until then, wetting the wound, bathing in the pool and the sea, and straining the area where the procedure was done are avoided.

What is recommended in the days after the procedure:

• keep the wound clean and dry and dress it according to the surgeon's instructions
• avoid heavy lifting and strenuous activities until the wound has healed
• mild pain is easily controlled with the usual analgesics recommended by the doctor
• come to the agreed dressing changes and to suture removal at the scheduled time
• contact the doctor if severe pain, redness, swelling, purulent discharge or a temperature appear
• you receive the histology finding in the following days, with recommendations for further monitoring

Risks and possible complications

Lipoma removal is one of the safest surgical procedures, and serious complications are extremely rare. Still, as with any intervention, it is important that the patient is aware of the possible, mostly mild and transient, occurrences. Most common are temporary occurrences in the wound area that resolve on their own or with simple treatment.

Minor bleeding or a collection of fluid (seroma) beneath the skin, mild wound infection, as well as bruising and swelling are possible. For lipomas that were large or more deeply located a somewhat more noticeable scar remains, and rarely a transient change of sensation in the skin around the incision can occur. If the lipoma was not removed in full with the capsule, there is a small possibility that it reappears in the same place over time.

It is important to know that with a proper surgical technique, sterile conditions and following the wound care instructions, most of these risks are reduced to the lowest possible level. That is exactly why lipoma removal should be entrusted to an experienced surgeon and carried out in a facility that provides controlled, hospital conditions — rather than attempting squeezing or home removal, which carries a risk of infection and incomplete removal.

Why have lipoma removal done at Medical Time

At Medical Time lipoma removal is performed by an experienced surgical team in modern, sterile conditions, with a careful and individual approach to each patient. From the first examination, through ultrasound assessment, to the procedure itself and histological analysis — everything is available in one place, quickly and without long waiting.

We attach special importance to making the scar as inconspicuous as possible, especially when the lipoma is on a visible part of the body. After the procedure we remain at your disposal for dressing changes, suture removal and interpretation of the histology finding, with clear recommendations for further care and monitoring.

• an experienced surgical team and removal of the lipoma in full, with the capsule
• a painless procedure under local anesthesia or, if needed, under analgosedation
• modern, sterile hospital conditions and high safety standards
• attention paid to a tidy and as inconspicuous a scar as possible
• mandatory histological analysis of the removed tissue for complete reassurance
• quick booking, an outpatient procedure and a return home the same day
• everything in one place — examination, ultrasound, procedure and further monitoring

Price

The price of lipoma removal depends on the size, depth and position of the change, as well as on the way the procedure is performed (under local anesthesia or analgosedation) and the included histological analysis. The final price is determined after an examination; look at the surgical services in the price list, and you receive a precise estimate and an appointment by calling.

• Surgeon's examination and assessment of the lipoma
• Removal of a smaller lipoma under local anesthesia
• Removal of a larger or more deeply located lipoma
• Histopathological (histological) analysis of the removed tissue

For an estimate and an appointment, call 062-399-888.

Frequently asked questions about lipomas