Lipoma removal: what happens, risks and recovery

Lipomas are soft fatty lumps under the skin. The NHS describes them as harmless and usually needing no treatment, ranging from pea-sized to several centimetres across, commonly on the shoulders, back, chest, arms, bottom and thighs. If it is not growing or causing trouble, leaving it alone is a perfectly reasonable choice.

The NHS says to see a GP about any new lump, and in particular if a lump becomes painful, red or hot, turns hard and fixed, or gets bigger. These features do not mean cancer, but they mean a lump should be examined, and a scan may be arranged if the diagnosis is unclear.

Removal is offered when a lipoma is growing or causing symptoms because of where it sits, according to the NHS, and the Milton Keynes leaflet lists the aims as relieving symptoms, giving reassurance and examining the tissue under a microscope. The Lincolnshire leaflet notes that surgery is the only way to remove a lipoma and check what it is. Cosmetic removal is usually not funded by the NHS, and the NHS notes that private removal is available.

Your GP or surgeon examines the lump, and the NHS says a scan may be arranged if the diagnosis is uncertain. You may then be seen at a pre-assessment clinic, where your history, tablets and any tests are reviewed. The Lincolnshire leaflet describes a pre-assessment visit with checking of medicines and consent.

If the operation is under local anaesthetic you can usually eat as normal, and if it is under general anaesthetic fasting instructions will be given. Ask which applies in your case, as the type of anaesthetic differs between hospitals and with the size and site of the lump.

• Tell the team about blood-thinning medicines and allergies.

• If you smoke, ask for advice, since the Lincolnshire leaflet notes chest infection is more likely in smokers having a general anaesthetic.

• Arrange a lift home, and someone to be with you for 24 hours if you have a general anaesthetic.

The leaflets differ on anaesthetic, which reflects local practice. Milton Keynes says local or general is decided at your clinic appointment, Oxford describes excision of lipomas under local anaesthetic, and Lincolnshire says general anaesthetic is usual, with a small lipoma possibly handled under local by a GP. Your own team will say what applies.

The surgeon makes a cut over the lump, separates it from the surrounding tissue and removes it, then closes the wound with stitches. If the lipoma proves bigger than expected, the Lincolnshire leaflet says a drain may be placed. Stitches either dissolve or are taken out about a week later, which Milton Keynes says a practice nurse can do. Most people go home the same day.

Milton Keynes lists pain, bleeding and bruising, wound infection, scarring and recurrence, and mentions that a small number of people have an inherited tendency to unusually red, raised scars. Lincolnshire adds a drain being needed, numb patches that can last up to three months, chest infection and blood clots, particularly with a general anaesthetic.

Recurrence is worth understanding. Milton Keynes says the lump may grow back, so ask your surgeon how often that happens in their experience for a lump in your location.

Oxford advises keeping the wound dry and clean for the first 24 hours after local anaesthetic, taking things easily for 48 hours to keep the bleeding risk low, and avoiding activity that stretches the wound for the first week. Wounds stay weak for up to six weeks, according to Oxford, and the scar matures over more than a year.

Milton Keynes says swelling and bruising settle in one to two weeks and most people return to work within two to three days, and that you should not drive for at least 48 hours after a general anaesthetic. Lincolnshire says not to drive for 24 hours. After a local anaesthetic, Oxford says driving is your responsibility, and you must be able to respond in an emergency as normal.

Contact your GP if the wound becomes very red, hot, painful or smelly, leaks heavily or if you develop a fever. Milton Keynes also suggests NHS 111 for non-emergency worries after discharge. For bleeding, Oxford advises firm pressure with a clean pad for about ten minutes without pausing to look, and an emergency department if it does not stop.