Lipoma and atheroma removal

Found a soft lump under the skin that does not hurt but is growing or getting in the way? Most often it is a lipoma, a benign growth of fatty tissue. An atheroma can look similar: a cyst filled with sebum and keratin (dead skin cells). Neither goes away on its own, and pills or creams do not remove them. The reliable way to get rid of them is surgical removal. At UKRMED it is done in the plastic surgery department with cosmetic suturing, so the scar is as discreet as possible.

Photo: Sikander Iqbal, Wikimedia Commons, CC BY 3.0

Lipoma or atheroma: the difference

A lipoma is a soft lump that moves under the skin and is usually painless. It grows slowly and can appear anywhere: back, shoulders, neck, arms, face.

An atheroma is firmer, attached to the skin and often has a dark dot in the centre, a blocked sebaceous gland duct. It can become inflamed: red, painful and leaking foul-smelling contents.

Only a doctor can tell them apart and rule out other growths, so it is best not to self-diagnose.

When surgery is needed

• the lump is growing or changing shape;
• it rubs against clothing or gets injured;
• the atheroma has been inflamed at least once;
• it is on the face or neck and affects your appearance;
• you need to know exactly what it is.

If an atheroma is inflamed now, the inflammation is treated first and planned atheroma removal is done once it settles: this lowers the risk of complications and gives a better scar.

How the surgery is done

1. Examination. The surgeon assesses the size, depth and mobility of the lump.
2. Local anaesthesia. The area is numbed, so the surgery is painless.
3. Removal. The surgeon makes an incision along natural skin lines and removes the lipoma with its capsule (the thin envelope around it). An atheroma is also removed with its whole capsule so it does not come back.
4. Cosmetic suturing. The wound is closed with a fine intradermal suture (the thread runs inside the skin, with no punctures on the surface) that later fades to a thin line.
5. Histology. The removed tissue can be sent for examination under a microscope to confirm it is benign.

Lipoma removal differs from liposuction: liposuction reduces fatty tissue volume, while a lipoma has its own capsule that must be removed completely.

Biopsy

If a growth looks unusual or grows quickly, the doctor may suggest a biopsy, taking a small piece of tissue for analysis. A punch skin biopsy is done with a small round instrument and leaves a tiny wound.

After surgery

• keep the dressing dry until the doctor says it can be changed;
• avoid steaming the area and saunas until the stitches are removed;
• stitches are removed at a follow-up visit;
• protect the scar from the sun for a few months.

If the scar looks noticeable after healing, it can be improved, see scar correction. Growths inside the mouth are removed by a maxillofacial surgeon, see neoplasm removal.

Prices

Sources

1. NHS. Lipoma. https://www.nhs.uk/conditions/lipoma/
2. NHS. Skin cyst. https://www.nhs.uk/conditions/skin-cyst/