Lipomas

Fatty Tumors as Seen on TV.

Most everyone knows what a lipoma is these days thanks to Dr. Pimple Popper.  (I’ll be sure to share some of her videos this week).  What may seem exciting on TV is actually an everyday occurrence in a dermatologist’s office.  We see lipomas in all shapes and sizes and in all kinds of locations every day.

What is a lipoma?  A lipoma is a circumscribed area of fatty tissue where the fat accumulates in a little “ball”.  Normally, we have fat throughout our skin.  Our skin is generally made of three layers- Epidermis, dermis, and fat.  The thickness of fat can vary depending on different parts of the body.  A lipoma occurs when some of these fat cells wall themselves off and grow independently.

Is there more than one kind of lipoma?  Yes, there are multiple types of lipomas.  Lipomas can be classified based on whether they contain fat cells only or other types of cells as well.  Plain lipomas have nice spongy fat cells only.  Here are a few of the other types:

Angiolipoma- contains blood vessels

Hibernoma – Brown fat instead of regular fat

Myolipoma -Contains muscle cells

Angiomyolipoma – Contains bloods vessels and muscle cells

Spindle Cell lipoma – Cells are spindle shaped instead of round or cuboidal

Are they cancerous?  No, almost all lipomas are benign, not cancer.

Do they hurt?  Most regular lipomas do not hurt to touch.  The fancier types of lipomas are more likely to be tender to touch.  Sometimes lipomas can cause pain when they impinge on a nerve or other tissue. 

What if I have a lot of them?  It is normal to have a few.  However, there are some inherited and acquired conditions where patients have dozens. 

• Dercum’s disease: This rare disorder causes multiple painful lipomas to grow, most often on the arms, legs, and trunk. It is also called adiposis dolorosa or Anders’ syndrome.
• Hereditary multiple lipomatosis: Also called familial multiple lipomatosis, this disorder is inherited, and patients get dozens or hundreds of lipomas.
• Madelung’s disease: This condition occurs most often in men who drink alcohol excessively. Also called multiple symmetric lipomatosis, Madelung’s disease causes lipomas to grow around the neck and shoulders.

Do I need to have my lipomas removed?  No, not unless they are tender, growing rapidly or causing pain due to impingement. 

How can lipomas be removed? They are commonly removed by surgical excision.  In the past 5 years or so we have used Kybella on some lipomas that were not amenable to surgery or where scarring wanted to be avoided.

If you have a lipoma that is causing you problems we would be happy to see you in the office.  However, sometimes we will refer to a plastic surgeon If the lipoma is too large to remove in our office.  Also, despite what television depicts, many insurance companies do not pay to remove lipomas unless they are problematic or suspicious in some way. 

_____________________________________________________

If you know someone who may find this article helpful, please share it with them! Follow us on social media this week, and subscribe to our growing YouTube channel! If you would like to receive these posts in your email inbox, Subscribe to our Site.