surgery · lipoma · lump under the skin · histopathology · Gdańsk
A lipoma is usually a benign lump made of fatty tissue, most often located under the skin. It is typically soft, movable, slow-growing and painless. Even so, every new, growing, painful, hard or unusual lump should be assessed by a doctor, because epidermal cysts, abscesses, enlarged lymph nodes, fibromas, post-traumatic lesions or, more rarely, tumours requiring more urgent diagnostics may look similar.
Lipomas and lipoma-like lesions are assessed and removed by: Piotr Rak, MD, PhD and Iwona Chruścicka, MD, PhD.
The most important answer
A lipoma is most often a benign, soft and movable lump of fatty tissue under the skin. It often does not require urgent treatment if it is small, painless and stable. A consultation is recommended, however, when the lump grows quickly, is painful, hard, fixed, deep, larger than a few centimetres, compresses a nerve, interferes with movement, is located in an irritated area or raises diagnostic concern. Removal may be considered for medical, diagnostic or aesthetic reasons, and the tissue may be sent for histopathological examination.
What is a lipoma?
A lipoma is a lesion made of mature fat cells. It most often develops in the subcutaneous tissue, just under the skin, but it may also occur deeper. In many patients it is single, although some people develop several or even multiple lipomas.
A typical lipoma grows slowly, is soft, elastic, well-defined and moves under the fingers. It usually does not cause pain. Pain may occur when the lesion compresses a nerve, is located in an irritated area, is large or has an unusual character.
Where does a lipoma most often appear?
- on the back, neck and shoulders,
- on the abdomen and chest,
- on the thighs and buttocks,
- on the forearms,
- around the shoulder or neck,
- in areas irritated by clothing, a belt, a strap or pressure,
- less often deeper in the tissues, where more detailed diagnostics may be required.
What does a typical lipoma look like?
- it feels soft or rubbery to the touch,
- it usually moves under the fingers,
- it usually does not hurt,
- it grows slowly, over months or years,
- the skin over the lesion usually looks normal,
- there is no visible skin opening, which is often seen with an epidermal cyst,
- it may be aesthetically or mechanically bothersome if located in an irritated area.
Seek medical advice sooner if the lump:
- grows quickly, especially within a few weeks or months,
- is larger than 5 cm or continues to enlarge,
- is hard, uneven or fixed in relation to surrounding tissues,
- lies deep, under the fascia or in a muscle,
- is painful without a clear cause,
- causes numbness, tingling, weakness or limited movement,
- recurs after previous removal,
- bleeds, becomes red, warm or drains fluid,
- appears together with fever, weight loss or general weakness,
- raises concern for the doctor or patient because of an unusual appearance.
Lipoma, epidermal cyst or abscess — how can they be distinguished?
Lipoma
It is most often soft, movable, located under the skin and has no opening on the surface. The skin over a lipoma is usually not red or warm. A lipoma does not drain any contents.
Epidermal cyst
An epidermal cyst is a cyst connected with the skin. It often has a visible point or opening on the surface and may contain thick whitish or yellowish material. It may rupture, drain and become inflamed.
Abscess
An abscess is usually painful, red, warm and tense. It may throb, grow quickly, cause fever or drain pus. An abscess requires more urgent assessment and often incision and drainage.
Enlarged lymph node
A lump in the groin, armpit or neck may be an enlarged lymph node rather than a lipoma. Lymph nodes may enlarge due to infection, inflammation, systemic diseases or malignant conditions. This is why location and a medical examination are important.
Does a lipoma have to be removed?
Not always. A typical, small, painless and stable lipoma may sometimes be observed. Removal is considered more often when the lesion:
- grows or changes its character,
- hurts or compresses a nerve,
- limits movement or interferes with daily functioning,
- is located in an area irritated by clothing, a belt or underwear,
- is aesthetically bothersome,
- is large or deep,
- raises diagnostic doubts,
- requires confirmation of the diagnosis by histopathological examination.
When is ultrasound needed?
A typical, superficial lipoma can often be diagnosed clinically, but ultrasound may be useful when the lump is larger, deeper, painful, grows more quickly, has an unusual structure or it is not clear whether it is a lipoma, epidermal cyst, lymph node, abscess or another lesion.
Ultrasound can help assess the location, size, depth and relationship of the lesion to surrounding tissues. If the lesion is suspicious, the doctor may recommend further diagnostics, more urgent referral or removal with histopathological examination.
What does surgical lipoma removal involve?
The procedure is usually performed under local anaesthesia. The doctor makes an incision in the skin over the lesion, separates the lipoma from the surrounding tissues and removes it completely if anatomical conditions allow it. Sutures and a dressing are then applied. The size of the scar depends on the location, size of the lipoma, skin tension and the healing process.
For larger or deeper lipomas, the scope of the procedure, bleeding risk, possible drain placement and postoperative instructions may differ. Details should be discussed on the service page and during the surgical consultation.
Is histopathological examination needed after lipoma removal?
Histopathological examination confirms what the removed lesion was. It is especially important if the lump was unusual, large, painful, fast-growing, recurrent or if the doctor wants to rule out another diagnosis. In many cases, sending the removed tissue for histopathology is a reasonable part of a safe treatment pathway.
Can a lipoma be a malignant tumour?
A typical lipoma is a benign lesion. However, one should not assume on their own that every soft-tissue lump is a lipoma. Fast-growing, hard, deep, large, painful, fixed lesions or lesions recurring after removal require more detailed assessment, because other soft-tissue tumours may need to be ruled out.
How to prepare for the consultation?
- note how long you have been able to feel the lump,
- check whether the lesion is growing and how quickly,
- tell the doctor whether the lump hurts, causes numbness, limits movement or is aesthetically bothersome,
- inform the doctor if similar lumps are present elsewhere,
- bring ultrasound results, histopathology results or records of previous procedures if you have them,
- prepare a list of medications, especially anticoagulants, and information about allergies,
- tell the doctor about diabetes, clotting disorders, keloids and wound-healing problems,
- do not massage, puncture or try to remove the lump yourself.
Patient pathway: from a lump under the skin to the right decision
This page is not a procedure page. It is intended to help the patient understand what a lipoma may be and when to proceed to the lipoma removal service page.
The patient feels a soft, movable lesion that may be a lipoma but requires assessment.
The doctor assesses location, size, depth, growth rate and features that may require further diagnostics.
If the presentation is typical, observation may be possible. If there are doubts, the doctor may recommend ultrasound or removal with histopathology.
The procedure involves surgical removal of the lesion, most often under local anaesthesia, with the option of histopathology.
Doctors assessing and removing lipomas
general and oncological surgeon
Assesses and removes skin and subcutaneous tissue lesions, including lipomas, epidermal cysts and other lumps requiring surgical evaluation.
Doctor profile →general and oncological surgeon
Assesses skin and subcutaneous tissue lesions, including lumps that require differentiation, removal and histopathological examination.
Doctor profile →Do you have a soft lump under the skin or suspect a lipoma?
Book a surgical consultation. The doctor will assess whether it is a typical lipoma or a lesion requiring ultrasound, observation, removal or histopathological examination.
FAQ – lipoma
Is a lipoma dangerous?
A typical lipoma is a benign lesion. A consultation is recommended, however, if the lump grows quickly, hurts, is hard, deep, fixed, large, unusual or recurs after previous removal.
Does a lipoma have to be removed?
Not always. Small, typical and painless lipomas may sometimes be observed. Removal is considered when the lesion grows, hurts, interferes with daily life, compresses tissues, is irritated, is aesthetically bothersome or raises diagnostic doubts.
How is a lipoma different from an epidermal cyst?
A lipoma is usually soft, subcutaneous, movable and has no opening on the skin. An epidermal cyst is more often connected with the skin, may have a visible point, contains thick material and may drain or become inflamed.
When is ultrasound needed for a lipoma?
Ultrasound is useful when the lump is larger, deeper, painful, grows quickly, has an unusual structure or it is not clear whether it is a lipoma, epidermal cyst, lymph node, abscess or another lesion.
What does lipoma removal look like?
The procedure is usually performed under local anaesthesia. The doctor incises the skin, removes the lipoma, applies sutures and a dressing. The removed tissue may be sent for histopathological examination.
Can a lipoma come back after removal?
After complete removal, a typical lipoma usually does not recur in the same place, but some people may develop new lipomas in other locations.
Who removes lipomas at Wyspa Medycyny Przyjaznej?
Lipomas are assessed and removed by Piotr Rak, MD, PhD and Iwona Chruścicka, MD, PhD.
Related pages
This page explains what a lipoma is. Procedure details, price and preparation should remain on service pages to avoid cannibalization.
Book a surgical consultation
If you have a soft lump under the skin, suspect a lipoma or have a lesion that is growing, painful or bothersome, book a consultation. The doctor will assess whether observation, ultrasound, surgical removal or histopathological examination is needed.
The information on this page is educational and does not replace a medical consultation. A lipoma is usually a benign lesion, but every unusual, fast-growing, hard, deep, painful or recurrent lump requires medical assessment. The diagnosis, need for ultrasound, surgical removal, histopathological examination and further diagnostics are decided by the doctor after examination. Medical review is required before publication.