A lipoma is a benign lump of fat under the skin. It is soft, moves under the finger and grows over years. Removal takes 30 to 45 minutes under local anaesthetic, leaves a line about the width of the lump, and the tissue goes to a laboratory. Removal is £695.
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Any of these needs to be seen the same day. If you are severely unwell, go to your nearest emergency department or call 999.
A lipoma is a collection of mature fat cells inside a thin capsule, sitting between the skin and the muscle. It feels soft, doughy and slightly mobile, and it is the commonest soft tissue lump adults get. Most sit on the shoulders, back, neck, arms or thighs.American Family Physician Salam, 2002
They are benign. A lipoma does not turn into a cancer. The reason a doctor examines one properly is that a small number of lumps that feel like a lipoma are not one, and the features that separate them are size, depth, growth rate and pain.NICE NG12, 2015
A typical lipoma is under 5cm, soft, painless, and has been there for years. It slides under the skin when you press one edge. Some people get several, and about 1 in 5 have a family member with them too.American Family Physician Salam, 2002
The referral threshold that matters is a soft tissue lump that is growing, is over 5cm, is deep to the muscle fascia, or is painful. Any of those means an ultrasound or an urgent specialist opinion rather than a removal, because a soft tissue sarcoma can present as a painless lump.NICE NG12, 2015
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Most lipomas are diagnosed by feel. The doctor measures it, checks whether it moves freely, presses to see whether it is tender, and asks how long it has been there and how fast it has changed. That examination takes about 5 minutes and settles the question in most cases.American Family Physician Salam, 2002
An ultrasound is arranged where the lump is over 5cm, deep, fixed or growing, and sonography identifies a typical lipoma reliably enough to settle most of those. Every lipoma removed here is sent for histology whether or not it looked typical, because the report is what turns a clinical opinion into a diagnosis.Radiology Inampudi, 2004
Leaving it alone
The right answer for most. A small painless lipoma that has not changed in years does not need removing and there is no medical reason to.
Ultrasound first
For a lump over 5cm, one that is deep, or one that has grown, imaging comes before any decision about removing it. Ultrasound is the first test rather than MRI.Royal College of Radiologists iRefer 8th edition, 2017
Liposuction of the lipoma
Leaves a smaller mark but leaves the capsule behind, so the lump comes back more often. It also produces no intact specimen for the laboratory.American Family Physician Salam, 2002
Excision with the capsule
The lipoma and its capsule lifted out whole through a line over the lump, closed with stitches, in one visit under local anaesthetic. Recurrence after complete excision is uncommon. You are told the length of the line and the price before you agree to it.General Medical Council GMC guidance, 2020
Removal takes 30 to 45 minutes for a typical lipoma. Stitches come out at 10 to 14 days. Expect a firm ridge under the scar for 6 to 8 weeks, which is healing tissue rather than a recurrence, and a line that fades over 6 to 12 months.Plastic and Reconstructive Surgery Mustoe, 2002
Bruising is common and settles in 2 weeks. Wound infection is uncommon after clean minor surgery and antibiotics are not given routinely to prevent it.NICE NG125, 2020
Measure the lump across its widest point with a tape and write the date beside the number. Do it again in 4 weeks. A lump that has not changed in size over a month is behaving like a lipoma, and that measurement is worth more to the doctor than a description.
Three questions decide the pathway, and you can answer all three before you arrive. How long has it been there, has it grown in the last 6 months, and does it hurt when nothing is touching it. Growth or pain moves you to imaging rather than removal.NICE NG12, 2015
Do not pay for an MRI on a small, soft, mobile lump that has been the same size for years. Ultrasound answers the question in the cases where imaging is needed at all, and most lipomas need none.NICE NG12, 2015
Do not have a lipoma removed by a method that leaves the capsule if you want it gone for good. A smaller scar today is a second procedure later.American Family Physician Salam, 2002
Step 1
Measured, moved and timed against your history. You are told whether it behaves like a lipoma and whether imaging comes first.
Step 2
Where it will be cut, how long the line will be, what the recovery is, and what it costs. Nothing happens until you agree to it.
Step 3
Removed with its capsule under local anaesthetic. A laboratory reads the specimen and your result comes back from the same doctor who took it out.
Ask before you book if you are not sure this is the right appointment.
No. A lipoma is benign and does not become cancerous. The reason to have one examined is that a small number of lumps that feel similar are not lipomas, and size over 5cm, depth, rapid growth or pain are the features that separate them.
Removal is £695, which includes the consultation, the local anaesthetic, the procedure, the histology report and the aftercare. A 30 minute consultation on its own, if you only want it examined, is £150.
Rarely, when the whole capsule is taken. Recurrence is more common after methods that break the lipoma up and leave the lining behind, which is why it is removed intact here.
The line is usually a little shorter than the width of the lump, because the fat delivers through a smaller opening than its diameter. It is red and firm for about 8 weeks and then fades over 6 to 12 months.
Often, yes, if they are small and in reachable areas. The doctor will say at the consultation how many can be done safely in one sitting and what that costs before you decide.
Most people do not. An ultrasound is arranged where the lump is over 5cm, sits deep to the muscle layer, has grown in the last 6 months, or hurts at rest.
Desk work, yes, and most people go straight back to it. Avoid heavy lifting, gym work and anything that stretches the skin over the wound until the stitches come out at 10 to 14 days. Keep the dressing dry for the first 48 hours and shower normally after that.
This page is general information about a condition and it is not a diagnosis. Treatment depends on what a doctor finds when they examine you, and no outcome is guaranteed. If you are severely unwell, or if any of the warnings at the top of this page apply to you, go to your nearest emergency department or call 999.
American Family Physician, American Academy of Family Physicians
Lipoma excisionSalam, 2002
General Medical Council
Decision making and consentGMC guidance, 2020
NICE
NICE
Surgical site infections, prevention and treatmentNG125, 2020
Plastic and Reconstructive Surgery
International clinical recommendations on scar managementMustoe, 2002
Radiology
Soft tissue lipomas, accuracy of sonography in diagnosis with pathologic correlationInampudi, 2004
Royal College of Radiologists
iRefer, making the best use of clinical radiologyiRefer 8th edition, 2017
Written by the clinical team at The Wellness. Awaiting clinical sign off.
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