Complications
Since a lipoma is a benign ulcer, complications rarely occur. However, the fat tumors can occur repeatedly after removal. During surgical removal of the lipoma, general surgical complications such as bleeding, infections, injury to vascular and nerve structures and wound healing disorders may occur.
If a lipoma is located in such a way that it is constantly exposed to friction or pressure, it may become inflamed by this irritation. The entry of bacteria into the lipoma leads to the formation of pus. The pus can come out through a bursting of the lipoma.
The inflammation can spread and the suitably symptomless lipoma begins to make itself felt. The skin reddens and the inflammation causes a feeling of pressure and pain. If a lipoma becomes inflamed, it should be removed.
This prevents further inflammation. If the lipoma is removed, however, you should be aware that a new lipoma is very likely to form at the same place. A lipoma can be removed – but does not have to be, as it does not tend to degenerate malignantly.
If the diagnosis is uncertain, it should be removed as a precautionary measure, since only microscopic examination can confirm the diagnosis. Depending on its size, it is removed under local or general anesthesia. In contrast to malignant tumors, there is no need to pay attention to safety distances during removal.
Since a lipoma is easy to see or to palpate, usually only a small incision is necessary. Special further treatment is not necessary, as the relatively small wounds can be sutured well. Each removed tumor must be examined again in small parts under the microscope (fine tissue examination) in order to reliably rule out malignancy.
From a medical point of view, the removal of a lipoma is not necessary in most cases. Since lipomas grow very slowly and non-invasively, the risk of metastasis and the development of a malignant tumor is very low. From a cosmetic point of view, the removal of a lipoma may well be possible.
Especially if the lipoma is located in a place where it is disturbing for the patient, e.g. in a joint region, or where it is disturbing for aesthetic reasons, e.g. in the face or hand area. (Under local anesthesia (local anesthesia) the skin is opened with a scalpel at the respective location.
The lipoma is “pushed out” through the skin gap and can then be cut away. It is important to note that the lipoma has a pronounced blood supply, so vessels drawing into the lipoma should be clamped to prevent bleeding. At the place where the lipoma was located, there is now an empty space, the extent of which is determined by the amount of tissue cut out.
In cases where this space is so large that a dent will appear, fatty tissue can be transplanted there from another location. Furthermore, for cosmetic reasons, excess skin can be removed, which is caused by the fact that the bulge that the lipoma has made is now no longer present. If it is a subfascial or intramuscular lipoma, the surgeon must prepare further in depth and also split the muscle fascia and possibly muscle.
In these cases, the surgery may take longer. If it is shown that the operation will take longer or become more complicated, general anesthesia may be used instead of local anesthesia. Instead of surgical removal, a lipoma can also be treated by liposuction.
This does not involve the complete removal of the lipoma. Instead, the content of the connective tissue capsule surrounding the lipoma is sucked out as much as possible. However, the capsule and the remains of the lipoma cells remain at the respective location.
Suction is usually only possible for larger lipomas, since smaller lipomas usually still have a very hard consistency. The advantage of liposuction is that the cannulas used virtually eliminate scars.This is especially interesting from a cosmetic point of view. Furthermore, the probability of dents in the skin is lower because the capsule remains behind and thus stabilizes the area.
However, disadvantages of suction are that not all cells are removed. As a result, there is a risk that the lipoma will grow again and will have to be suctioned off again after a certain time. In addition, the pathological assessment of lipoma cells after suction is much more difficult, since many cells are destroyed by the mechanical pressure during suction.
