I accidentally found a soft circular protruding lump on my skin and I’m not sure if it’s a lipoma or a cyst. I observed it for a while and it not only didn’t shrink, but also gradually grew bigger and started to affect my appearance. Upon examination, I found out that it is a lipoma. How should I deal with it?
What is a lipoma?
Lipoma is a common benign tumor of the skin. It is a mass of overgrown fat cells, which is normal adipose tissue and does not harm the body. The cause of lipoma is currently unclear.
Lipomas mostly grow on the surface of the skin on the head, neck, limbs, shoulders, abdomen, and back. If they are on the back, they usually grow larger. They may also grow in the colon or muscles. They appear as flat and round on the surface of the skin, and there is a sliding sensation when pressed. They mostly have capsules, and sometimes grow multiple. Usually, there is no pain, but if the lipoma compresses nerves or other tissues, it may cause local pain symptoms.
In terms of treatment, observation can be conducted first. Generally, when the size of the lump is not large and there is no change, it can be treated without active intervention. However, if it grows on the back of the neck or back, it is recommended to deal with it as soon as possible. Besides affecting the sleep quality of the patient, if the lump grows larger, it may also compress the surrounding nerves and cause local soreness.
Lipoma’s high-risk population
The cause of lipoma has not been found clearly in medicine. What is more certain is that it is more common in families with a history of lipoma. If someone in the family has a lipoma, the chance of the family members also having it is also higher.
According to clinical statistics, the high-risk groups are:
- Those with a family history of the disease
- Patients with special diseases (Cowden syndrome or Gardner’s syndrome)
- Those between the ages of forty and sixty
Differences between lipoma and cyst
When lipomas first grow, they look a bit like cysts on the surface, both are round, but their internal structures are not the same.
Cysts are pockets of keratin debris under the epidermis, formally known as epidermoid cysts. They appear as round bumps, usually with small openings similar to blackheads on the surface, which are attached to the epidermis. There is no sliding sensation when pressed, and pus may flow out when pressed hard.
Lipomas usually have a larger size and area than cysts. The most obvious difference is that lipomas do not have a small opening in the center, and there is a sliding sensation when pressed. They do not discharge pus when squeezed.
Do we have to seek medical attention for lipomas?
Many patients choose to observe the lump first, and seek medical attention only when it becomes larger or painful. Although lipomas are mostly benign in clinical practice, I sincerely recommend not to judge by yourself. When there is an unknown lump on the body, let a professional doctor diagnose it. Different diagnoses correspond to different treatment methods, so it is best to let the doctor help confirm whether observation, slicing, or immediate surgery removal is needed. The doctor usually diagnoses the lipoma by palpation or by doing a small biopsy, and the result can be obtained quickly.
Pay special attention to the following four situations: rapid tumor growth, pain with secretion, changes in skin color, and surface wounds that cannot heal. In these four situations, it is necessary to seek medical attention as soon as possible to ensure health!
Are there non-surgical methods?
At present, non-surgical treatment options include local injection of steroids to shrink the lipoma, but it cannot be cured. If there is a need for scarless cosmetic surgery, minimally invasive liposuction surgery can be used, which has only a 2-3mm incision. However, compared with open surgery, this method may not be able to completely remove all of the tumor tissue and is more prone to recurrence. Therefore, the most fundamental method is still to recommend open surgery to reduce the chance of recurrence.
Moreover, some lipomas have vascular components (angiolipomas) or grow deeply, compressing fascia or nerves and causing pain, which also require surgical removal.
The most common benign tumors of the skin are lipomas and cysts. As a surgeon who has performed many surgeries to remove various sizes and types of skin tumors, I am very familiar with it. Because of the high accuracy, I recommend early surgery to solve the inconvenience.
Lipoma surgery overview
Lipoma surgery usually uses local anesthesia. A cut is made on the skin, and the surrounding tissue is separated. After completely removing the lipoma along with the outer capsule, the wound is sutured, and the surgery is completed. The surgery time is usually not long, so there is no need for hospitalization. Small lipomas can also be considered for early surgery to minimize the wound, and it is easier to take care of after surgery before the lipoma becomes larger.
Preoperative precautions for lipoma surgery
- Please wear lightweight or loose clothing on the day of surgery.
- No fasting is required before surgery.
- The bladder needs to be emptied before surgery.
Postoperative precautions for lipoma surgery
- It is normal for the wound to have slight bleeding for the first three days after surgery, please do not worry.
- There may be bruises around the surgical area, which generally take about a week to recover.
- After the anesthesia wears off, there may be a slight pain, which is generally within the tolerable range. If there is no history of drug allergy and require pain relief, analgesics prescribed by a physician can be taken.
- Wound care: Gently clean the wound with a sterile cotton swab dipped in physiological saline or boiled cold water in the morning and evening. After wiping off the dried blood clots and tissue fluid, apply ointment and cover with gauze.
- Ice packs can be used for temporary soreness and discomfort after surgery. If there is redness, swelling, or pain in the surgical area, please return to the hospital for examination immediately.
- Within one week after surgery, avoid contact with water on the wound, do not take a bath or swim before the wound heals, and use waterproof adhesive tape during bathing, then change the dressing.
- Avoid smoking, drinking alcohol, or eating spicy food within one week after surgery.
- Stop taking aspirin, anti-inflammatory drugs, ginkgo biloba, and steroids within one week after surgery.
- Before the wound heals, avoid vigorous exercise that may pull on the surgical area to prevent the wound from rupturing.