Lipoma: What It Is and How It Is Removed

What is a lipoma?

A lipoma is a benign tumour made of mature fat cells, wrapped in a thin capsule, that grows slowly in the tissue just beneath the skin. It is the commonest soft-tissue tumour: many people have one and never mention it.

It is easy to recognise: a soft, mobile lump that slides under your finger, with well-defined edges, that does not hurt and has grown slowly —sometimes over years. It appears most often on the back, shoulders, nape, arms, thighs and abdomen, though it can arise almost anywhere.

It is not cancer and it does not turn into cancer. But the uncomfortable part deserves to be said plainly: not every lump under the skin is a lipoma. A sebaceous cyst, an inflamed lymph node, an abscess, a fibroma or —rarely but really— a liposarcoma can look similar. That is why what is removed is sent for histopathology. That is the difference between removing a lump and doing the job properly.

When does a lipoma need surgery?

A small, stable, symptom-free lipoma can simply be watched. Removal is indicated when any of the following applies:

• It is growing. A lipoma changing size quickly must be assessed; rapid growth is the finding that mandates investigation.
• It hurts or bothers you. When it compresses a nerve or rubs against clothing, a bra strap or a belt.
• It gets in the way or shows. On the face, neck, nape or shoulders, the cosmetic reason is reason enough.
• It is deep, firm, fixed, or larger than 5 cm. These features are not typical of a simple lipoma: here, prior imaging and pathology of the specimen are not optional.
• The diagnosis is in doubt. If it is unclear what it is, it gets investigated. Full stop.

How is lipoma removal performed?

Most lipomas are removed in the office under local anaesthesia, as a 20–45 minute outpatient procedure. No prolonged fasting, no hospital stay; the patient walks out the same day.

The anaesthetic is infiltrated, a small incision is made over the lesion —planned, wherever possible, along the skin’s natural lines or inside a crease so the scar stays discreet—, the lipoma is freed from surrounding tissue and removed with its capsule intact. Removing the whole capsule is what stops it regrowing in the same place.

Haemostasis is checked, the wound is closed in layers with fine suture and, if the lipoma was large, a small drain or a compressive dressing may be left for a few days to stop fluid collecting in the residual space. The specimen is always sent for histopathology to confirm the diagnosis. The result is delivered and explained at the follow-up visit.

Large, multiple, deep (intramuscular) lipomas, or those in delicate areas, are scheduled in theatre under sedation or general anaesthesia as appropriate.

See the full guide: Post-surgical recovery and care.

Technique and scar: the plastic surgeon’s judgment

A lipoma can be removed in many ways. The difference between doing it and doing it well lies almost entirely in the scar left behind — and in visible areas (face, neck, décolletage, shoulders) that scar is all the patient will see for the next twenty years.

• Minimal, well-oriented incision, along the skin’s tension lines or hidden in a natural crease.
• Removal with the capsule intact: substantially reduces the chance of recurrence.
• Layered, tension-free closure with fine suture: tension on the edges is the leading cause of wide or hypertrophic scars.
• Histopathology of the specimen: confirms it was what it looked like. Not a formality; the standard.
• Postoperative scar care: silicone and sun protection, especially in patients with a keloid history.

Lipoma, sebaceous cyst or lymph node? How to tell them apart

Many different things sit under the skin, and patients call them all “a lump”. Telling them apart is half the job, because each is treated differently.

• Lipoma: soft, slides freely under the finger, grows very slowly, painless, with no pore or opening in the overlying skin. It is fat.
• Sebaceous (epidermoid) cyst: firmer, tethered to the skin, often with a visible central punctum or pore. It can become inflamed, red and painful and discharge foul-smelling material. It is excised whole, with its capsule: if it is merely drained, it comes back. Read more on the sebaceous cyst removal page.
• Inflamed lymph node: appears in the neck, armpit or groin, is usually tender, arises over days —not years— and often accompanies an infection. Not primarily surgical: the cause is investigated.
• Abscess: hot, red, painful, rapid onset. A minor emergency, not elective surgery.
• A lesion that demands investigation: firm, fixed to deeper planes, fast-growing, larger than 5 cm, or painful. Here nothing is assumed: imaging and biopsy.

Possible risks and complications

Lipoma excision is minor surgery with very few complications, but no surgery is zero risk. The possible —uncommon— ones are: bleeding or haematoma in the cavity, fluid collection (seroma), especially after large lipomas, wound infection, a more visible scar than expected (particularly in patients prone to keloids), temporary altered sensation around the scar, and recurrence if the capsule was not removed intact.

All of them are discussed by name at the consultation, before anything is signed. If you have a history of keloid scarring, tell your surgeon before the operation: it changes both the planning and the postoperative protocol.

Who is a good candidate?

Anyone in good health with one or several lipomas that are growing, painful, bothersome or worrying. The consultation examines the lesion, determines whether prior imaging (ultrasound) is needed, and decides whether it is best removed in the office or scheduled in theatre. All surgery carries risk and requires a prior medical assessment. Results may vary according to each patient, their anatomy and their individual healing process.

Before and after

Most patients want to see before-and-after photographs before deciding. Out of respect for each person’s privacy, Dr. Arístides Arellano shows real cases —always with documented consent— during your in-person consultation, where you can review results from patients with a starting point similar to yours. Results may vary from patient to patient.

Approximate price in Puebla

The cost of lipoma removal depends on its size, depth and location, on the number of lesions, and on whether it is done in the office under local anaesthesia or in theatre. It is defined at the consultation, where a clear quote is provided that includes histopathology. Approximate price — the definitive cost is set at your private consultation with Dr. Arístides Arellano.

Credentials

Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.

Lipoma removal with a surgical CO₂ laser

A lipoma is a benign fatty tumour and the treatment is to remove it whole. The surgical CO₂ laser — here a NovaPulse (Lumenis · Luxar) — is used for the skin incision: CO₂ emits at 10,600 nm, a wavelength that tissue water absorbs almost completely. It therefore cuts in a very thin layer and seals the finest vessels as it goes: it incises and coagulates in the same pass.

In practice that means a cleaner incision and less bleeding in small, superficial lipomas. For large or deep lipomas, or those near important structures, conventional surgery remains the appropriate route: size dictates the instrument, not the other way round.

A non-negotiable rule: every excised lesion is sent for histopathology. That is the only way to confirm it really was a lipoma. Dr. Arístides Arellano, plastic surgeon in Puebla, applies this without exception.

Documented training in skin and soft-tissue lesion surgery

A lipoma is removed in minutes; the difference between a plastic surgeon and anyone else is the scar left behind. Dr. Arístides Arellano is fully licensed — professional and specialty cédula — and is a Fellow of the international dermatologic-surgery society:

• Fellow — International Society for Dermatologic Surgery — Nueva York · abril de 1991
• Speaker: surgical treatment of skin tumors — Jornada de Alergia, Dermatología y Cirugía Estética · BUAP, noviembre de 1996
• 2nd Argentine Congress of Dermatologic Surgery — pre-congress course — Asociación Médica Argentina · Buenos Aires, 12 de octubre de 2006
• DGP specialty authorization — AE-002008 — Dirección General de Profesiones (DGP) · México D.F., 27 de marzo de 1990

Trust is verified, not promised. All 210 scanned documents —degree, licences, diplomas, publications and certificates, from 1977 to 2025— are open in Dr. Arístides Arellano’s credential archive, alongside an explanation of the difference between a specialty licence and a board certification.

Recovery · step by step

• Day 1Mild discomfort controlled with simple analgesia. Normal life resumes; the wound is kept dry.
• Days 2–7Dressing changes as advised. Exercise and strain that stretches the operated area are avoided.
• Days 7–14Sutures removed. The histopathology result is delivered and explained.
• Weeks 3–4Full return to exercise. Scar care begins (silicone, sun protection).
• Months 3–12The scar matures, lightens and flattens progressively.

Frequently asked questions

Every figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.

Educational content; it does not replace a medical consultation. Results may vary from person to person.