Despite the reassuring words of your doctor about its benign nature, you are not too reassured by this lipoma that has taken shape right in the middle of your thigh … What is it exactly? Should we intervene? Professor Gérard Lorette, professor emeritus of dermatology at the University Hospital of Tours, sheds light on the causes, diagnosis, and treatment of lipomas.
What is a lipoma?
Rather soft, of variable size, the lipoma is a mass of subcutaneous fat. Completely benign, this excess fat located under the epidermis can measure between 1 and 20 cm, sometimes more, and form anywhere on the body: stomach, arms, breast, back … but also brain, muscles, tendons, bone! No area of our anatomy is safe from a lipoma! For now, if we know the mechanism behind the formation of a lipoma, the runaway cells of fatty tissue, we do not know what causes this excessive proliferation.
Is it serious?
If the lipoma is inherently harmless to health, certain locations can have serious consequences. This is more particularly the case with lipomas that develop in-depth, near organs or those that reach a critical size, says Professor Lorette. “A lipoma located in the brain, on a muscle, a tendon or a bone can cause compression of the vessels or nerves nearby and cause pain or even paralysis”, describes the dermatologist.
How do you know if it is a lipoma?
Only a general practitioner or a dermatologist can diagnose a lipoma. Palpation of the lump is usually sufficient to diagnose and distinguish the lipoma from another lump: soft, malleable, the lipoma has regular contours and rolls under the fingers. The sebaceous cyst, with which it is often confused by patients, looks like a hard lump with a hole in the middle. If in doubt, the doctor can take a biopsy and have the sample analyzed. Lipomas usually grow independent of any disease. However, they can be part of the symptoms of certain pathologies. This is the case with Dercum’s disease, a rare condition that affects obese people, especially women. Also known by the term painful adiposis, it is characterized by the presence of multiple painful lipomas in the lower limbs, which are difficult to relieve, which have the unfortunate tendency to reform after their removal.
Lipomatosis is characterized by multiple lipomas, organized, and in-depth. This genetic disease, of which Launois-Bensaude disease is a part, occurs in two forms: with lipomas concentrated in the region of the neck and trunk and symmetrically dispersed (this is the form that mainly affects men suffering from comorbidities such as diabetes, high blood pressure, and alcoholism); with lipomas present in the abdomen and at the roots of the thighs, where they can be bothersome and compress the surrounding vessels, nerves and muscles.
Treatment of a lipoma
Lipoma rarely requires treatment. But if it becomes painful or if its unsightly appearance bothers patients, then its removal is indicated. The operation is performed by outpatient surgery (without hospitalization): this is the most appropriate technique, underlines Professor Lorette. Avoid, on the other hand, liposuction techniques that are accompanied by a high rate of recurrence, warns the specialist.