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About "lipoma"

I think it is the second most common tumor under the skin. As its name suggests, it is a "tumor of fat". Usually, it feels like a soft and soft ball. It can be done anywhere, but tends to have more back, shoulders, and buttocks. Although it is slow, it may gradually expand and become melon-sized. The more vascular form is called “angiolipoma” and is often painful and often occurs.

"Lipoma" surgery

An incision is made in the skin to remove the lipoma. After that, the skin is sewn up, but as the lipoma disappears, it remains as a cavity under the skin, so bleeding may accumulate inside. This is called a hematoma. A small amount of hematoma will naturally absorb, but when a large amount of hematoma occurs, it is necessary to open the wound and remove the hematoma. After the operation, a drainage tube may be inserted to prevent bleeding to prevent hematoma. On rare occasions, there are lipomas in the muscle. I bleed a lot at this time, so I recommend surgery at a general hospital.

Intramuscular lipoma Tumors made of fat, like lipomas, but malignant are called liposarcoma. For accurate diagnosis of lipoma and liposarcoma, excision and tissue examination is required.

Surgery fee

• The exposed area is the area below the head, face, neck, elbows and knees.
• Another measure is when the lipoma is attached to the muscle membrane.
• In addition to the charges, initial consultation fee, re-examination fee, prescription fee, and drug fee will be charged.

Q&A FAQ

Does the surgery hurt?

There is pain during local anesthesia (similar to anesthesia for dental treatment), but there is little pain during surgery.

Does it hurt after surgery?

I have a pain on that day and until the next day. For small wounds (1 cm or less) there is almost no pain. For pain, we will prescribe an internal medicine for pain relief.

Can I take a bath?

When stitched, showering is permitted from the next day. Rinse the wound with a shower and then wipe the surface with the prescribed disinfectant. After that, have the bandage cover it. With the CO2 laser, there is no problem with showering and bathing from the day. Ask the prescribed ointment to be applied externally.

How long does it take to remove the yarn?

5-7 days on the face, 14 days on the palms and soles, 7-10 days otherwise.

When will you know the results of the tissue test?

It will take about 10 days because we ask a specialist in skin pathology at Tottori University to make a diagnosis.

Q How can you develop lipoma?

A At present, the cause is not clear. Benign cutaneous tumors are often of unknown cause.

Q Do I absolutely have to take lipomas?

A Even if you have a lipoma, you do not have to take it if you do not have a problem in your daily life.
However, assuming that it is a lipoma, there may be other diseases that are not lipomas.
It is not easy to make a definite diagnosis of lipoma without a pathological examination, so it is better to remove it as much as possible.

Q Will lipomas grow larger?

A: It depends on the case, so I can not say anything, but it often grows slowly.
It may be larger than 20 cm, and may stay within a few cm.
You should suspect other illnesses that seem to grow rapidly.

Q Can lipomas become malignant?

A lipoma itself does not become malignant. It is possible that what was thought to be a lipoma was actually a liposarcoma (malignant tumor).

Q Can lipomas be taken outpatient?

A Lipoma can be taken outpatient unless it is extremely large or difficult to operate.

Q Can I go to work after I have my lipoma?

A Except in exceptional cases, you can go to work the next day after removing the lipoma.
If you have a small lipoma, you may be able to go to the treatment from the same day.

What is lipoma

Lipoma of the left shoulder

Lipomas are subcutaneous tumors that often occur on the upper limbs, shoulders, and back of an adult and are one of the most common plastic surgery operations. The cause is unknown, but it tends to occur in areas that are susceptible to irritation. When it is placed in a place that is difficult to see, such as on the back, it causes little pain. Although it is possible to diagnose by palpation and visual inspection if it is a typical one, it may be difficult to make a diagnosis due to the difference in site and depth. Therefore, MRI and ultrasonic examinations are useful for distinguishing from other diseases, and in the case of a large single event, it is common to perform image examination before surgery.
Treatment of lipoma

The principle of treatment is complete resection. Lipomas are not liquids and cannot be removed with a syringe. If it is large or deep, surgery is performed under general anesthesia, but considering the size and depth, the general condition and personality of the patient, the social situation, etc., the anesthesia method and the presence of hospitalization are considered. Schedule surgery. Usually, an incision is made directly above and cut in bulk to avoid damage to the capsule. In most cases, a soft straw-like bleeding tube is inserted into the wound to prevent blood from collecting in the space removed after the operation. The tube usually comes off within a week, but it is decided based on the drainage volume. The excised one is confirmed by histopathological examination for the presence of malignant findings. It is common to remove the thread from the 8th day after the surgery within 2 weeks, and after that you will have a normal life. In the case of a single case, it is not necessary to see the doctor once the thread removal is completed, but in the case of a person who tends to have lipoma constitutionally and frequently has a new lipoma, a new lipoma may often occur and a surgery may be required again.

If you notice a lump

　Many people may not see the hospital because they do not have symptoms such as pain even if they notice a subcutaneous lump, but sometimes they are not malignant and may not be lipomas. Don't judge yourself and go to a hospital to see a specialist.
Although it depends on the type of lipoma, in plastic surgery, in order to make scratches less noticeable, surgery is performed with the smallest possible incision to prevent recurrence due to leftovers. In addition, we are striving to make scratches less noticeable by performing plastic surgical sutures.

A lipoma is a benign tumor composed of matured adipocytes and is one of the so-called “common disease” common diseases. Lipomas are also said to be the most common disease of dermatophytes and mollusks among patients with skin tumors who visit the dermatology clinic. Lipomas can occur anywhere in the body, but in the fat areas of the neck (fires, especially the back neck), shoulder blades, upper arms, back, thighs. It often develops in areas with adipose tissue, but sometimes in muscle, on the periosteum, or in the dermis. It is often recognized under the skin as a relatively soft mass called elastic soft.

Epidemiology

As mentioned above, lipoma is a very frequent disease. It is often found in the age range where fat tends to accumulate, especially in the 40s and 60s. The frequency is high for both men and women, but it is considered to be rather high for men.

Clinical symptoms

Lipomas are often found in the subcutaneous fat layer, as described above.
In most cases, it is not continuous with the skin or the underfloor, but in the case of the dermis-generating type (relatively high), there is continuity with the skin, and in the case of
intramuscular-generating type, it is continuous with the underfloor. You may feel like you are.

Lipomas do not hurt or itchy, so it may be difficult to notice if you are in an invisible position.
You will feel a lumpy mass when you touch it. In some cases, it grows larger and you can see it just by looking at it.
It seems that many people usually see a medical institution with a size of 1 cm to 15 cm.

As mentioned above, it usually grows slowly.
Lipomas by themselves do not harm your health or shorten your life, but if they are too large, they can cause problems with your dressing and can impair your exercise.

In addition, because it may be a problem to distinguish it from malignant liposarcoma, which is a disease similar to lipoma, it is often removed if found.

It is often elastic (soft as well as fat), but a subtype of lipoma called angiolipoma may be tender.
Also, hemangiolipomas often feel a little hard.

It is often in one place, but it often occurs in 5-8%. If it occurs frequently, it is often the case with angiolipoma described above.

Clinical subtypes include:
Diffuse lipomatosis
, benign contralateral lipomatosis, lipomatous
nevus
.
Angiolipomas can also be considered a clinical subtype, as they also have a clinical feature of multiple incidence.

Diffuse lipomatosis

It is a rare disease that occurs in infants under 2 years old, and it is a rare disease in which lipoma is seen throughout the body such as the limbs and trunk. Lipoma may be found not only in the subcutaneous adipose tissue but also in the muscle and internal organs.

Benign contralateral lipomatosis

It is a disease in which lipomas occur frequently symmetrically around the neck, as the name implies. Symptoms of lipoma are seen symmetrically on the neck, upper arm of the shoulder, chest, abdomen, and thighs. It is a rare disease that is often seen in people who drink a lot of alcohol.

Lipomatous nevus

A tumor consisting of mature adipocytes that develops from adipose tissue that has somehow entered the dermis for some reason, and it appears to pop up on the surface of the skin and is often seen in the buttocks, hips, and thighs. It's not such a rare disease and is often seen.
Clinically, it is divided into a classic type and a sporadic type, and the classic type is a multiple pedunculated lesion that occurs from early childhood. The sporadic type is a dome-shaped nodule that often develops as an adult.

Pathological classification

Lipomas can also be classified as pathologically as follows, not clinically.
A normal lipoma has a capsule filled with mature adipose tissue.

Angiolipoma

Lipomas, which have many vascular components in mature adipocytes, tend to occur more often, and are often slightly rigid and small.

Fibrolipoma

Collagen fibers are often found in mature adipocytes, and are often found in areas such as the back of the neck and upper back where pressure is easily applied.
They tend to adhere and are somewhat difficult to remove.

Spindle cell lipoma

It is a benign tumor with no dysplasia in the cells, which is accompanied by proliferation of spindle-shaped cells similar to fibroblasts in the lipoma.
It is commonly found on the back neck and shoulder blades of middle-aged men.

Polymorphic lipoma

It is a rare lipoma that contains various cells in the lipoma.

Inspection/diagnosis

Its characteristic appearance and palpation allow easy diagnosis.
However, it may be necessary to differentiate it from liposarcoma, which is a malignant tumor.
It is difficult to make a qualitative diagnosis only by CT or ultrasonography, and MRI examination is necessary.

If you suspect a lipoma, it may be realistic to surgically remove it and perform a pathological examination.
Of course, if there is an environment that allows easy access to image diagnosis such as MRI, it is desirable to make a diagnosis in advance using MRI.

Our hospital's commitment to lipoma treatment

We are designed to minimize scratches. When removing a lipoma, a quick surgery is performed to avoid damaging the surrounding tissue as much as possible. We also support if you have a lot of lipomas.

Our hospital treatment method for lipoma

At present, the only treatment for lipomas is surgical removal, which is ineffective for topical and oral medications.
Therefore, the focus is on how to make the wound small and remove lipoma except in special cases.

Usually, local anesthesia is given to the skin just above the lipoma, and a skin incision is added, and the incision is carefully advanced to the lower layer.
When a lipoma is identified, it is removed along with the capsule.
The excised lesion is then closed with dermal and epidermal sutures, and the treatment is complete.

・Caution 1 In
the case of lipoma originating in the dermis, if continuous dermis is not removed at the same time, recurrence is likely to occur.
If there is continuity with the skin by palpation, or if it is continuous with the skin by ultrasonography, it is necessary to remove the skin including the skin in a spindle shape.

・Point 2 A
lipoma may be a tuft, so if you take one large lipoma and feel at ease, another small lipoma may be hidden.

Surgical therapy

An incision is made along the skin flow to scrape through the adipose tissue and find the lipoma. When a lipoma is found, the film is removed with an appropriate layer and the lipoma is removed without damaging the surrounding area. Complete the surgery by suturing cleanly.

Massaging method

It is a method used to make the wound smaller when removing a lipoma.
As the name implies, squeeze out or massage the lipoma through a smaller incision line.

Surgery method of massaging
First, a neat solution or diluted anesthesia is injected around the lipoma, and the tissue surrounding the tumor is exfoliated in advance.
Then, a minimal incision is made, and the lipoma, which already has detached, is massaged or squeezed out from the lipoma.
After that, dermis and epidermis are sutured as usual.
This method is characterized by smaller wounds and less bleeding and invasiveness, and can be said to be one of the so-called minimally invasive surgery.

However, it does not mean that the scratches are smaller than the conventional one, and that the scratches are not eliminated.

However, it may not be suitable for fibrolipoma with strong adhesion.