Condition: Skin Lesions and Lipomas

A lipoma is a lump under the skin that occurs due to an overgrowth of fat cells and slowly grows under the skin in the subcutaneous tissue.

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What is a lipoma?

Lipomas are soft fatty lumps that grow under the skin. Doctors consider lipomas to be benign tumours, which means that they are non-cancerous growths.

They can occur anywhere on the body where fat cells are present, but they tend to appear on the shoulders, chest, trunk, neck, thighs, and armpits.

What are the different types of lipomas?

Lipomas can be different based on where they are and their shape. Most of the time they are just under the skin. Sometimes they can be in or under muscle. Some lipomas are fusiform, others have multiple lobes. A special type of lipoma has more blood vessels (angiolipoma).

What causes a lipoma?

Lipomas are a common benign tumour that occur in about 1 in 100 people. They are more common in patients who have obesity, high cholesterol, liver disease or glucose intolerance.

It’s unusual to develop more than one or two lipomas, unless you have a rare inherited condition called familial multiple lipomatosis. This can cause lipomas to develop all over the body and most patients will have a family history. Lipomas may also occur more frequently in people with rare medical conditions, such as:

  • Gardner’s syndrome
  • Cowden syndrome
  • Madelung’s disease
  • Adiposis dolorosa

What are the symptoms of a lipoma?

They are usually painless and are most often found on the back, shoulders, arms, buttocks, and upper thighs.

They feel soft and “doughy” to touch and range from the size of a pea to a few centimetres across. They normally grow very slowly and don’t usually cause any other problems. Occasionally, lipomas can develop deeper inside the body, so you won’t be able to see or feel them.

How is a lipoma diagnosed?

The diagnosis is made by taking a history and clinical examination. It is common to perform an ultrasound. This is to confirm the diagnosis but also to assess the anatomy of the lipoma. Sometimes they can lie within or underneath a muscle and this can influence treatment.

Patients with a large lipoma may be asked to undergo an MRI scan. This can be helpful in planning treatment. Very rarely, lipomas are misdiagnosed for a cancer called a liposarcoma. An MRI scan is a helpful way of ensuring that the lipoma is nothing to worry about. If there is any doubt, your surgeon will perform this test.

When should I see my healthcare provider about lipomas?

You should see a doctor for any lump as it is safer to check it than leave it without knowing what it is. It may not need to be treated if it is not dangerous or troublesome but it is always safer to check than assume it is safe.

If a lipoma is troublesome, seeing a healthcare provider can help you to decide when it should be treated.

How are lipomas treated?

Lipomas can be managed without surgery and with careful observation. However, if there is any change in size or if the lipoma becomes symptomatic or causes a cosmetic defect it should be removed.

The treatment for a lipoma is normally an operation to remove it.  The type of anaesthetic needed will depend on the size and location of your lipoma. It will normally be done as a day case procedure under local or general anaesthetic.

Surgery can usually be performed in approximately 30 minutes, but this depends on the size and number of the lipomas and the method of removal.

After the lipoma has been completely removed from under the skin, the incision will be meticulously sutured closed with dissolving sutures. The tissue will routinely be sent to the pathology department for examination under the microscope and you will be informed of the result.

Skin Lesions and Lipomas Specialists

Our consultants are all either heads of service at London teaching hospitals, or have played major roles in clinical innovation, employing their collective expertise, knowledge and deep experience to deliver the best care possible.