(li-po’mah)-a benign tumor composed of fat cells. Noone knows the exact cause but there seems to be at least 3 types of benign lipomas. One is reported to occur after localized trauma. It appears as a single lipoma & is very slow growing. Another is an angiolipoma which tends to occur in multiple areas all over the body & has more blood vessels within it. It is due to a genetic predisposition & grows even more slowly. Another rare form occurs within muscles & is even less well understood. Some authors have recommended removing the actual muscle as well as the lipoma because of a high recurrence rate if just the intramuscular lipoma is removed.
They are benign but can cause problems if they grow to a sufficient size to compress adjacent structures such as nerves or arteries. Lipomas are a rare cause of carpal tunnel syndrome where the lipoma presses on the median nerve at the wrist. The treatment is to remove the lipoma. The vast majority of lipomas are so close to the skin surface that they will never cause a problem other than a cosmetic problem.
Lipoma removal is cosmetic surgery however many times one can’t tell the difference between a lipoma & a cyst or other tumor. I had one patient whose presumed lipoma turned out to be a metastatic melanoma cancer. Thus, I think most health insurance carriers cover their removal because you never know what your dealing with until the pathologist’s report is complete. My preferred method of lipoma removal especially in the case of multiple angiolipomas is liposuction – the incisions are much smaller & can be hidden in strategic areas. Lipomas can recurr after liposuction since one can never be sure that the liposuction removed every bit of the lipoma but the tradeoff of less scarring is worth it especially in the case of angiolipomas. However, if you are not sure you are dealing with a benign lipoma conventional excision is a better approach to prevent spread of a possible malignancy or liposuction induced cell damage which in turn prevents accurate diagnosis by the pathologist.