What Are The Methods & Techniques Are Generally Implemented For Lipoma Removal Extraction

 

Dr. Gurukaran, MRCS, DNB, M.Ch, Personiks.

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Lipomas are benign fatty tumors that may be removed for symptomatic or cosmetic reasons. Common removal techniques are limited by the risk of scarring and recurrence. The following paper provides a review of lipoma excision techniques and possible alternative technologies that have been tested or are being developed. Of the reviewed methods, liposuction is the most effective overall in removing adipose tissue, but is hindered by associated costs. Deeper lipomas may be ablated with laser technologies, although larger incisions are required. Additionally, study results of ultrasound and pharmaceutical methods are promising, but require FDA approval before becoming a prevalent practice.

Lipomas are benign tumors composed of subcutaneous adipose tissue. They are typically asymptomatic, but may cause discomfort with direct pressure. Removal is typically done for symptomatic or aesthetic purposes. The rare variant of liposarcoma requires aggressive surgical removal and close monitoring for recurrence. Lipomas are typically removed by excision, with potential complications of bleeding, infection, seroma, scarring and recurrence. The following review focuses on the current methods of lipoma excision, as well as alternative removal methods, including cauterization, liposuction, and laser removal. Experimental techniques, such as ultrasound, micro wave, and pharmaceutical treatments, are also reviewed.

The following methods and techniques are generally implemented for lipoma extraction.

Pre-operative steps

The borders of the lipoma are marked with a surgical pen, using palpation to detect the edges. The skin is cleansed with chlorhexidine or alternative disinfectant and a ring block is performed using lidocaine with or without epinephrine. The patient is draped to maintain a sterile operating field.

Incision and pressure method

The surgeon performs a linear incision about 1/3 to 1/2 the diameter of the lipoma, on the skin directly above the lipoma. Usually Metzenbaum scissors are inserted and spread circumferentially around the tumor in order to break up fibrous bands connecting the fat lobules to the surrounding tissue. Once separated, the lipoma is then expressed applying digital pressure to the edges of the mass.

If necessary, a hemostat may be used to provide traction and the incision may be extended to facilitate removal. The resultant cavity is explored to ensure adequate hemostasis and complete removal of fatty tissue. This method of extraction is most effective for encapsulated lipomas but is commonly employed in the removal of non-encapsulated lipomas as well.

Punch (enucleation) technique

This method utilizes a 4–6 mm punch biopsy tool, 3 mm curette, tissue scissors, and a hemostat. After pre-operative preparations are completed, the surgeon stretches the skin over the lipoma perpendicular to skin lines. Once taut, the punch tool is centered over the lipoma and is applied with downward pressure and rotation of the tool, removing the epidermis and dermis.

A curette is inserted through the incision and the surrounding tissue is scraped with the curette. Once freed, the lipoma is extracted through the incision using a hemostat. Repeated curetting may be necessary in order to deliver portions of the lipoma through the opening. In larger lipomas, multiple small incisions or punches may be necessary for segmental extraction.

Elliptical excision method

For large or complicated lipomas, elliptical excision may be necessary. This involves removing a football-shaped wedge of skin in order to maximize visualization of the surgical field. Once exposed, the lipoma is dissected away from the surrounding tissue and removed as a single mass or in segments.

While this method results in larger scars than previously described methods, elliptical excision may improve cosmesis by removing excess stretched tissue that arises from slow expansion of the fatty tumor. The removed fat may or may not be sent for histopathologic analysis. Potential complications include bleeding, infection, seroma, scarring, pain and recurrence .

The Average Cost Of Lipoma Removal

The cost of surgery for the removal of a Lipoma is typically ranges from INR 10,000/- to 25,000/- depending on the case. Please be aware lab and consultation are charged separately, but sometimes Lipomas do not need to be sent to the lab. Lipomas on back, front and shoulders particularly larger Lipomas can be more expensive as they can be considerably more difficult to remove.

What To Expect During Breast Reduction Surgery Recovery Period?

When your breast reduction surgery is complete, dressings or bandages will be applied to the cuts. An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal.

A small, thin tube will be placed under the skin temporarily to drain any excess blood or fluid that may collect.

It can take up to six weeks to fully recover from breast reduction surgery. You may need to take off work for a week or two and shouldn’t drive for at least a week. The final appearance of your breasts may not be apparent for many weeks or months after the surgery.

First Week of Recovery

Plastic surgeons recommend wearing a sports bra 24 hours a day for up to three months after breast surgery. Stitches are removed after a week or two and your breasts will be tender. There will be swelling and bruising which will slowly fade. As the surgical area heals you will apparently experience some itching and dryness. The removing dressings on depends on how fast your wounds healed.

To reduce painful swelling, you should increase water intake and reduce sodium consumption. This helps to flush the fluid out of the body. You must avoid stretching, difficult exercise and heavy weight lifting for up to six weeks after the breast reduction surgery. You may drive again after some weeks when it is no longer painful to wear a seatbelt.

You will receive postoperative instructions after your surgery. Follow the instructions carefully without any fail it helps you to heal properly. The instructions will include the types of medications that will be applied in the surgical area, oral medications to help heal and reduce the risk of infection and when to follow up with the surgeon.

Long-Term Recovery Considerations

Recover from surgery may be different for everyone. For example, some of you may experience hypersensitivity of the area. Some may experience numbness of the surgical area, for up to a year, following surgery. And there are some cases, who may not have any type of these sensations.

Also, how people heal from scars can also be different. There will be visible scars that may fade over time but, in many cases, will not disappear.

The breasts may swell and become tender at the first menstrual cycle after the procedure. Patients may continue to experience occasional pain, especially during menstruation, for several months after the procedure.

There are a few things you need to know about the recovery period, Ask your plastic surgeon following questions

   1. Where will I be taken after my surgery is complete?

   2. What medication will I be given or prescribed after surgery?

   3. Will I have dressings/bandages after surgery? When will they be removed?

   4. Are stitches removed? When?

   5. When can I resume normal activity and exercise?

   6. When do I return for follow-up care?

Visit Personiks Cosmetic & Plastic Surgery clinic in Hyderabad for more details about Breast Reduction Surgery & cost in Hyderabad.