Lipomas are very common tumors that can pop up anywhere on the body.
Made of adipose or fatty tissue, they are most often benign, but based on location, symptoms, and in size, they do have potential risks: If a lipoma develops along the neck, it could pose a risk to breathing or swallowing. Painful lipomas can affect day-to-day activities, posture, or exercise.
It’s unclear what causes lipomas to develop, but genetics is thought to play a significant role. Often, people will note a family history of lipomas, but they can also arise from several diseases and genetic syndromes, including Madelung’s disease, Dercum’s disease, Gardner’s syndrome, and hereditary multiple lipomatosis.
When to see a doctor
Although very rare, liposarcoma, a malignant lipoma, can occur. If a lipoma increases in size, have it evaluated by your dermatologist to rule out malignancy. Occasionally, patients may perceive a lipoma to be increasing in size when, in fact, the lipoma is stable but an increase in muscle mass behind the lipoma makes it appear more prominent. I routinely ask patients that note a possibly expanding lipoma about new exercise routines to determine the possibility that this may be playing a role in the perceived change in size.
Can they be shrunk or eliminated without surgery?
Lipomas can potentially be minimized or shrunk with steroid injections that cause atrophy of the fatty tissue. Some patients with numerous and/or multiple small lipomas may consider this option for some cosmetic improvement. The challenge with this approach, in my experience, is that it potentially only benefits small lipomas (less than 1 centimeter in size). This procedure also tends to have a high recurrence rate, simply because it is only shrinking the size but not eliminating the lipoma altogether. Liposuction has also been used to treat lipomas. This would still be considered surgical, but it has a reduced risk of scarring.
If surgically removed, what’s the likelihood of them recurring?
The likelihood of a lipoma recurrence after surgical excision truly depends on whether the entire lipoma was removed, how the lipoma was removed, whether it was encapsulated or well defined, and whether it had a deeper component that may have involved the fascia or muscle (a deep-seated lipoma). The recurrence rate is around 5 percent after surgery, but this rate may go up based on these factors