A soft, rubbery lump beneath the skin that moves freely when you press it — if this sounds familiar, you may have a lipoma. Lipomas are among the most common benign (non-cancerous) lumps that patients present with, and the vast majority are entirely harmless. But there are times when removal is the right decision, and knowing when to seek specialist advice is important.
What Is a Lipoma?
A lipoma is a slow-growing, benign tumour composed of fatty tissue. They develop just beneath the skin and are most commonly found on the upper back, shoulders, neck, armpits, and thighs. They can range in size from a small marble to several centimetres across. Most people notice them simply as a painless, soft swelling that has been present for months or years without changing significantly.
Are Lipomas Dangerous?
The overwhelming majority of lipomas are completely benign and carry no risk of becoming cancerous. They do not require treatment unless they are causing symptoms or you would prefer to have them removed for cosmetic or practical reasons. That said, it is important to have any new or changing lump assessed by a doctor to confirm the diagnosis and rule out the small number of cases where further investigation is warranted.
When Should a Lipoma Be Removed?
Removal is recommended or worth considering in the following situations:
- Pain or tenderness: Some lipomas press on nearby nerves or blood vessels, causing discomfort. This is more common with angiolipomas, which contain blood vessels and can be genuinely painful.
- Rapid growth: A lipoma that is growing quickly should always be assessed by a specialist, as rapid growth can occasionally indicate a different type of lesion requiring further investigation.
- Large size: Larger lipomas (generally over 5cm) may be more difficult to treat non-surgically and are more likely to cause mechanical problems or cosmetic concern.
- Location causing problems: Lipomas on the back, shoulder, or buttock may make it uncomfortable to sit, lie, or wear certain clothing.
- Cosmetic concern: Many patients simply want the lump removed because it bothers them aesthetically, particularly if it is on a visible area.
- Diagnostic uncertainty: When it is not completely clear from examination that the lump is a simple lipoma, excision and histological analysis provides a definitive diagnosis.
What Does the Procedure Involve?
Lipoma removal is typically a straightforward day-case procedure performed under local anaesthetic. A small incision is made over the lump, and the lipoma is carefully dissected from the surrounding tissue and removed intact. The incision is closed with fine sutures, and most patients return home within an hour of arriving at the clinic. The excised tissue is routinely sent to the laboratory to confirm the diagnosis.
Recovery is quick for most patients. The area may be bruised and tender for a week or two, and you should avoid strenuous activity for a short period, but most people return to normal activities within days.
Will It Come Back?
When a lipoma is excised completely, recurrence is uncommon. If any residual tissue is left behind, regrowth is possible — this is why complete excision by an experienced surgeon gives the best long-term result. Liposuction can be used for some lipomas but carries a higher recurrence rate than open excision.
How Is a Lipoma Different From a Cyst?
Patients often confuse lipomas with cysts, and both are extremely common. A sebaceous (epidermoid) cyst is firmer, often has a central punctum (a small dark spot on the skin), and contains a cheesy material rather than fat. Both can be easily removed at Precision Surgery under local anaesthetic as a day-case procedure.
Get It Checked in Birmingham
If you have a lump that is worrying you — whether it is painful, growing, or simply something you would like removed — we welcome you to book a consultation at Precision Surgery in Birmingham. Our specialist plastic surgeon will assess your lump, provide a clear diagnosis, and discuss your options without any pressure to proceed with surgery.
