Dermatology What Causes Lipomas

Lumps of fat under the skin What to do about lipomas

A lipoma is a benign tumor in which the fat cells proliferate, usually just under the skin. This then feels like a round or oval bump. Usually, however, it does not cause any discomfort. Lipomas are very common.

Typical places where the benign tumors develop are the legs, shoulders, arms and back, explains Dr. Maria Wiedner, chief physician for plastic surgery at the Malteser Hospital in Bonn.

A typical lipoma has a rounded capsule around the fatty tissue and can then be pushed back and forth a little under the skin. Lipomas that lie under muscles are less common. For example on the forehead or in the neck.

Lipomas can occur in anyone

The fat bumps have nothing to do with obesity. Slim people can get them just like overweight people. Men are slightly more likely to be affected than women. As a rule, lipomas only appear in people over the age of 30 - very rarely in children.

Classic lipomas grow slowly, they are only a few centimeters in size. In exceptional cases, however, they can also be the size of a palm. If the tumor doesn't hurt or cause any other problems, it doesn't necessarily need treatment.

Lipomas that are firm to the touch or that grow very quickly need to be examined

However, conspicuous hardening of a lipoma is suspect, warns the doctor Maria Wiedner, as do many of her colleagues. She advises if the lipoma feels firm and hard to definitely have it examined. Because something else could be hidden behind it. Even if a lipoma grows very quickly, the person affected should have this clarified with a doctor. It is important to confirm that the lipoma is benign. Malignant lipomas are rare. .

Liposarcomas are very rare, but they are malignant

A lipoma is malignant in about one in a hundred cases. Then it is a so-called liposarcoma. A liposarcoma cannot be moved easily because it has grown together with the surrounding tissue. Malignant liposarcomas mainly develop on the back and neck.

45-year-old Elke R. had developed a lipoma on her back. The dermatologist assured that it was a harmless change. But the fat bump grew and grew to a diameter of 5 centimeters. In addition, the lipoma was located directly on the spine. When lipomas press on nerves or blood vessels or grow too large, they can cause numbness or tenderness.

Therefore Elke R. decided to have the fat tumor excised on an outpatient basis. She was absolutely satisfied with the result. But it is not certain whether she will be spared further lipomas. Because lipomas can reappear, even in the same place. And even relatively often.

Why some people get the fat lumps and others don't is still unknown

There could be a connection with other diseases, says the surgeon Maria Wiedner. Lipomas occur more often in metabolic diseases or in diabetics. A family disposition is apparently also possible.

Incidentally, lipomas cannot be prevented. Even if someone loses massively, the size of the fat bump won't change.

Removal is seldom necessary

Anyone who is bothered by the lipoma for optical reasons alone and therefore decides to remove it must bear the costs of the operation themselves. In the event of complaints, however, or if malignancy has to be ruled out, the health insurance will pay for it. The procedure is performed under local anesthesia or under general anesthesia. It all depends on where the lipoma is, how deep and how big it is.

A small incision over the "nub" is usually enough and then the lipoma can be peeled out or detached, explains the plastic surgeon Wiedner. Then the place has to be sewn. If there is a large accumulation of fat, which is known in advance to be a benign ulcer, the fatty tissue can also be removed by liposuction, said Wiedner.