A lipoma is a benign tumor composed of fatty tissue and occurs in about 1% of the general population, usually being found in adults from 40 to 60 years of age. They are soft to the touch, moveable, and usually do not cause pain. While they can be found anywhere there is fat, they are most common in the forearms, trunk, and thighs. They generally are small (less than one centimeter) but can be quite large as isolated masses.
As a plastic surgeon, I have seen many lipomas and the standard treatment is to excise them. (cut them out) While small ones ‘pop’ out quite easily, large ones do not do so and require a more substantial incision and resultant scar to remove. Plus, large ones will need a drain after surgery as they tend to develop fluid collections. (seromas)
Given that they are benign tumors composed of dense fatty tissue, it is reasonable to consider the use of LipoDissolve injections as a method of non-surgical treatment. LipoDissolve is well chronicled as a cosmetic treatment for unwanted small collections of fat. While lipomas a bit more dense, they should still respond to the injection therapy. Lipodissolve solutions are usually a mixture of phosphatidycholine and deoxycholic acid (PCDC) that works to break down the fat cell walls, causing release and resorption of the released fat.
Over the past three years, I have treated 7 adult patients (5 female, 2 males) that had fairly large lipomas (between 4 and 16 cms), mainly on the back and shoulders. They did not want surgery nor did they want scars, particularly on or around the shoulder areas. All responded to an injection series in obtaining signficant shrinkage of the lipoma. In some cases, it was clear that there was either residual lipoma or scar left which felt like nodules. The average number of injection treatments was 6 (4 to 9) to get the lipoma to the point that the patient did not want any further treatment. While some patients are more than one year after treatment, it is too early to say whether any lipoma recurrence may develop.
LipoDissolve injections do work in both small and large lipomas in my experience. However, the patient must accept that it is not a fast process and may take up to 6 months with numerous injection sessions to get the best result in larger lipomas. Each injection session is associated with swelling and some pain that lasts about one week after the injection session. It is likely that lipomas may respond faster with combination therapy such ultrasound and injections. Or one can treat them with liposuction and use Lipodissolve injections to treat any residual tumor.
Dr. Barry Eppley
Indianapolis, Indiana