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Excision of a Large Lipoma on the Shoulder using Tumescent Technique

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Published on May 12, 2016

This lovely patient drove a few hours to come see me. She has had this lipoma removed in the past but it grew back. As you can see it's pretty big in size. Perhaps the largest lipoma I have ever removed.
If an area of the skin this size needs to be locally anesthetized it's common to use the "tumescent technique" which is the same way I numb people when I perform body liposuction. Essentially, this is when we dilute the lidocaine, in saline (with epinephrine and bicarb as usual), so we can spread it out to a wider area. Lidocaine in large volumes in our body is actually life threatening, so we always monitor how much lidocaine we are administering if we know we need to anesthetize a large area.
I do believe there was "normal" fat above this lipoma that I had to remove to get to this actual lipoma, so there may be a slight depression in the area when it fully heals, but my fingers are crossed because it looks pretty good so far! I DON'T use liposuction to remove lipomas because this "breaks up" the lipoma and I do believe there is high chance that a lipoma reoccurs this way.

I'll post her follow up pictures in an update video in the near future!

Thank you for watching!!
A lipoma is slow-growing, benign growth of fat cells. It is contained in a thin, fibrous capsule and found right under the skin. A lipoma is typically not tender and moves around easily with slight pressure. A lipoma is not cancerous and treatment generally is not necessary. There is also a condition called familial lipomatosus, where people develop multiple lipomas, especially on the arms and legs, and other family members have these growths as well. If the lipoma is on a pressure-bearing area, it may create discomfort and this is when people seek removal. People also request removal because they don’t like the appearance of these bumps. Often a small incision can be made over the lipoma and they can be “popped” out easily. This is a simple in-office surgical procedure under local anesthesia.

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This video may contain dermatologic surgical and/or procedural content. The content seen in this video is provided only for medical education purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

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