Lipoma, benign fatty tissue – what can you do about it?

Fat lump or lipoma are common, and the larger they are, the more unsightly. Dermatologist Dr. Francis Wu explains what they are and how to remove them.

Fat tissue cells

Another name for a fat lump is a lipoma. Lipoma is a benign tumor made up of adipose tissue cells and is located in the subcutaneous tissue (the part under the dermis).

lipoma fat bump
Heredity plays a role

It is a common condition and occurs mainly in middle age. It is unclear how lipomas arise, but there is a hereditary component. Excess weight does not play a role.

They are often localized on the neck, shoulders, upper arms, back and thighs. It feels doughy and the overlying skin is normal in color and texture. It moves freely over the skin and is attached to the base layer. A lipoma has a smooth surface.

Slow growing

Lipoma grows very slowly and can reach 2 to 10 cm in size, sometimes even larger. A rapidly growing tumor is probably not a lipoma.

About 7% of people with lipomas have multiple fat bumps. They are spread over the body, but can sometimes also be found in 1 body part. Lipomas generally do not cause any complaints, but sometimes it is painful when a lipoma pushes against a nerve.

Lipoma variants
  • Angiolipomas: 10% of lipomas are the benign highly vascularized angiolipomas and are located in the neck, neck, palms, soles of the feet. These lipomas are smaller 0.5-5cm and can cause more pain. The complaints can occur at a young age, a study showed an average age of 17 years.
  • A rare lipoma variant is adiposis dolorosa (Dercum disease). . It is characterized by multiple painful and slow-growing lipomas that may be located just under the skin of the upper arms, thighs, trunk, and around joints. In addition to multiple painful lipomas, obesity, headache, stiffness in the morning, fatigue, dry eyes and dry mouth, and easy bruising are common. But also heart problems, high blood pressure, sleep disorders, depression and memory and concentration disorders can be related. It occurs most often in postmenopausal women, the average age is 35 years. Heredity plays an important role. It occurs in 16% of men. In addition to multiple painful lipomas in the torso, buttocks, upper arms and legs, obesity, fatigue, dry eyes and dry mouth and depression also occur.
  • Other bumps under the skin: sebaceous gland cysts, lymph nodes, fibromas, neurofibromatosis, lymphomas.

Often the clinical picture is clear to make a diagnosis of lipoma. On physical examination, a fat lump is attached to the lower layer, has a smooth surface, is well demarcated (where the fat tissue begins and ends) and is separate from the skin. Sometimes ultrasound, CT scan or MRI with possibly tissue research is used if the image is unclear.


Lipomas do not disappear with cold or hot packs, nor with massages or diets.

Cosmetically disturbing lipomas or lipomas that cause complaints such as pain can possibly be removed on an outpatient basis.

Superficial and well-encapsulated lipomas can be easily removed surgically under local anaesthesia, but poorly demarcated lipomas are not.. Because it is deeper than originally thought (back, shoulder blades, ribs) or between vulnerable structures such as nerve and blood vessels.

On youtube for the procedure

There is a chance that a lipoma will come back.

Liposuction for small lipomas is another alternative and causes less scarring. With medium-sized (4-10 cm) and large lipomas (>10 cm), the chance of recurrence is high because it is not always possible to remove the entire lipoma.

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