Symptoms

A lipoma on the head is asymptomatic, it feels like a bulging little ball filled with jelly. Sometimes it hurts under pressure. Lipomas are benign tumors that do not infiltrate surrounding tissue.As such, in most cases they do not cause pain.

In exceptional cases, however, they may be located in awkward places and squeezed when moved. The targeted application of pressure on the lipoma can also cause pain without this being an indication of malignant degeneration of the lipoma. However, if, in addition to pain, rapid growth and a non-displaceable structure of the tumor is noticeable, a clarification by a physician is urgently required.

In this case, the growth may be a malignant liposarcoma. However, liposarcomas are much rarer than lipomas. A benign special form of lipoma is the angiolipoma.

This contains blood vessels that are often blocked by blood clots (thrombi), i.e. thrombosed. This often causes pain. Young men are particularly affected; half of the patients have several angiolipomas at the same time.

Therapy

A lipoma is a benign tumor, which means that it is not malignant and, if it does not interfere or cause pain, it does not necessarily need to be removed. Lipomas on the head are often unattractive. In these cases, the lipoma can be surgically removed by a dermatologist or a surgeon.

If the lipoma lies superficially under the skin, as is the case in most cases in the neck, a local anesthetic is sufficient. The skin is incised and the lipoma and its connective tissue capsule are pressed out. The skin is then closed again with a suture.

In the case of subfacial lipomas, which we often find at the transition from forehead to hairline, surgical removal is somewhat more complicated. The surgeon must first expose the muscle and fascia in order to remove the lipoma underneath in its entirety. Here, too, a local anesthetic is usually sufficient to keep the risk of narcosis as low as possible.

Such deeper lying lipomas on the head can press on nerves and thus cause great damage if they are not removed in time. In both cases, scars remain, which are not necessarily aesthetic. It must therefore be carefully considered before the procedure whether it is better to leave the lipoma in situ, if this is possible, or whether removal is desired.

A more recent procedure to keep scarring as minimal as possible is liposuction. In this procedure, the lipoma is suctioned out through a very small incision. Especially in the head area, this method guarantees a relatively scar-free result.

Although this technique is already used daily in liposuction procedures, the complete removal of the lipoma is sometimes difficult. There is a risk that the tumor will not be removed without leaving a residue and that it will grow again after the operation. There is a risk of bleeding and infection of the wound during every surgical procedure, followed by poor healing, but these are rare in head lipoma removals. The degenerative tendency of lipomas is practically non-existent, therefore the lump can be simply left in place and placed under observation, provided it is not perceived as disturbing.