Diagnostics
In addition to a clinical examination (palpation, testing of shifting), ultrasound and puncture (histological examination of the tissue) are used for a detailed examination of the lipoma. The lipoma is characterized by its elastic consistency and good mobility and differentiation from the rest of the skin tissue. In case of localization in the orbit, an MRI or CT may also be useful for precise positional control.
Diagnostically, the benign lipoma has to be distinguished from a malignant liposarcoma. A malignant degeneration of a lipoma is rare, but should be clarified, especially if the lipoma increases rapidly in size. However, liposarcoma occurs very rarely in the facial region.
Furthermore, the Madelung syndrome must be excluded. This is characterized by symmetrically arranged lipomas in the face, shoulders and neck area and the formation of entire fat aprons. Often, the Madelung syndrome is also characterized by a liver dysfunction caused by chronic alcohol abuse. In the face, a sebaceous cyst must also be separated from a lipoma. This may require an examination by a dermatologist, as the delimitation can sometimes be more difficult.
Therapy
Although it is a benign increase of fatty tissue, it can cause pain due to a suppressive growth or it can be disturbing visually or by an increase in size. In this case, removal of the lipoma can be considered. If the lipoma does not interfere, it does not necessarily have to be removed or treated.
There are various options for the removal of the lipoma: In addition to removal via a skin incision within an operation, the lipoma can also be removed via suction of the fatty tissue. After examining the lipoma, the treating physician can determine which form of therapy is appropriate. The operation can be performed under general anesthesia, but also under local anesthesia.
The lipoma is opened through a small skin incision and then removed. The incision is then sutured. Overall, this is a relatively simple and uncomplicated procedure.However, it becomes more difficult if the lipoma is located near large nerves.
In this case, more care must be taken not to injure the nerve. The operation can also be more complicated if the lipoma is located on or in the eye, and the removal must be carried out through an access on the eye. The advantage of the operation is a complete removal of the lipoma, as the surrounding connective tissue capsule can also be removed, whereas in lipoma liposuction only the fatty tissue is removed.
The disadvantage of the operation is the possibility of scarring, which can be disturbing for the patient, especially in the face. If the lipoma occurs in a place such as the forehead, where the scar is considered unaesthetic, lipoma suction may be considered. However, it should be noted that the risk of the lipoma coming back during surgery is much lower than during liposuction.
