Lipomas are noncancerous lumps that develop under the skin. Most are harmless, but in some situations, removal is recommended. A surgical procedure called excision is the primary removal method.

Lipomas are fatty lumps that develop under your skin. They’re common, and most lipomas are harmless and don’t need to be removed.

Surgery is sometimes used to remove lipomas for cosmetic reasons or if they’re causing pain. It’s rare for lipomas to return after surgery.

Lipoma removal surgery is usually a minor procedure, though it can be more invasive if you have multiple lipomas or if they’re very large.

The largest ever lipoma was 22.7 kilograms (kg), or about 50 pounds (lbs.), and was surgically removed in 1894. In a 2018 case study, researchers reported a 14-kg (31-lb.) lipoma that took 6 hours to remove.

Keep reading to learn more about what to expect during surgery to remove a lipoma.

Lipomas are round or oval fatty masses found below your skin. They aren’t cancerous.

According to the National Health Service, lipomas:

  • are usually soft or squishy
  • range from the size of a pea to a few centimeters across (a centimeter is about 0.4 inches)
  • may move slightly if you press on your skin
  • generally don’t cause pain
  • grow slowly

Lipomas most often develop on your:

  • upper back
  • shoulders
  • arms
  • buttocks
  • upper thighs

And less commonly on your:

  • thigh
  • shoulder
  • calf

Lipomas generally don’t need to be removed. Your doctor may recommend surgery if your lipoma is:

  • getting bigger
  • causing pain
  • bothering you cosmetically

Excision is usually the only treatment that can completely remove a lipoma. Excision is the surgical removal of a lipoma through a cut in your skin. It’s usually performed in a doctor’s office or surgical center.

Your surgeon will give you specific instructions on how to prepare for your procedure. They may tell you:

  • to wash the area with antibacterial soap before the procedure
  • avoid shaving around the lipoma
  • avoid taking blood thinners or ACE inhibitors on the day of your procedure
  • stop taking other medications in the period leading up to your procedure

Most people receive local anesthesia. Local anesthesia is when a surgeon injects medication around the lump to numb the area. If the lump is particularly large, you may receive sedation or general anesthesia through an IV.

Sedatives are drugs that make you feel more relaxed, and general anesthesia puts you asleep.

During surgery

Lipoma removal is usually a simple procedure. Here’s a general idea of what you can expect:

  1. A local anesthetic is injected around the lump to numb the area.
  2. Your doctor will make a cut in your skin over the lipoma.
  3. They’ll then remove the lipoma and stitch the wound.

Your surgery will likely take less than an hour and possibly less than half an hour.

Usually, the incision will be about the width of the lipoma. Your surgeon may also perform the squeeze technique. During this variation, the lipoma is pushed through a smaller incision. The squeeze technique can help minimize scarring, but it’s often ineffective for larger lipomas.

You’ll be able to go home on the same day as your procedure. Depending on what type of stitches your surgeon uses, they’ll either dissolve by themselves or need to be removed after 7 to 10 days.

You’ll likely have some discomfort around the surgical site for a few days. The pain can usually be managed with over-the-counter medications like ibuprofen or acetaminophen (Advil or Tylenol).

You may have a small amount of swelling. You can help manage it by applying ice over your bandages.

You’ll likely be able to return to most of your daily activities right away, but your surgeon may recommend waiting a couple of days before exercising and about a week before performing vigorous sporting activities.

Lipomas very rarely grow back. If they do, your doctor may recommend a second surgery.

Lipoma surgery is generally a safe procedure, but every surgery comes with some risks. You may bleed or develop an infection. It’s important to speak with your doctor if your stitches break or if you develop symptoms that may indicate an infection, such as:

You may have a permanent scar after your procedure.

Do lipomas ever come back after surgical removal?

It’s rare for lipomas to come back after surgical removal. They sometimes return if the surgery didn’t remove the entire fibrous capsule around them.

Is surgery the only option for complete lipoma removal?

Surgery is usually the only option for removing a lipoma completely. Most lipomas don’t need to be removed.

Are there alternative treatments to lipoma removal surgery?

Very large lipomas may be removed with liposuction. Injection lipolysis, or chemically reducing the number of fat cells with an injection, is another option that may reduce scarring.

Injections aren’t currently approved by the Food and Drug Administration (FDA) for treating lipomas, but researchers are continuing to examine their use.

What causes lipomas?

It’s not completely understood why lipomas develop, but about two-thirds of lipomas have gene abnormalities. There is a theory that trauma to the soft tissue in the area may play a role in their development.

Do lipomas ever turn cancerous?

Lipomas are benign, meaning there’s no risk of them becoming cancerous. A lipoma’s appearance can be similar to liposarcoma, a rare type of cancer that develops in your fat.

Do lipomas run in families?

About 2% to 3% of people with lipomas have multiple lipomas caused by genes inherited from their parents. This condition is called familial multiple lipomatosis. It affects men about twice as often as women and usually develops in your 20s.

Lipomas are fatty lumps that develop under your skin. They usually don’t require treatment, but your doctor may recommend surgery if a lipoma is causing you discomfort or bothering you cosmetically.

Lipoma surgery is usually a quick and simple procedure that can be performed with local anesthesia to numb the surrounding area. Larger lipomas may require sedation or general anesthesia.