Will surgery for lipomas prevent their recurrence?
Q: I have been recently diagnosed for lipoma on the lower back. The size that is required for the removal is about 4-5 inches. The doctor has advised to get it removed under general anaesthesia considering the large size. Another doctor has suggested to wait and watch and consider excision only if it starts growing and becomes painful. I do not have any pain but I have discomfort in the back. The ultrasound and clinical examination has confirmed the absence of liposarcoma. Are there any disadvantages/implications of not getting it removed (except for cosmetic) assuming that it does not grow larger or painful? Can it stop growing or become painful and stay as it is for the rest of the life? Will it grow bigger? Does the size or lipoma and degree of pain have any correlation? What are possible disadvantages/implications/complications in removing it vis-a-vis leaving it as it is? If its advisable to remove, who should do the surgery a general surgeon or a cosmetic surgeon or some other specialist? How important and essential is it to get the surgery done under general anaesthesia? Can more lipomas develop after surgery on other parts of the body? Can removal help in preventing getting more lipomas? Does the size of lipoma affect the convenience, complications and quality of the results of the surgery? Is it better to remove it when it is small?
A:It is advisable to have the lipoma removed because it has grown to the size of 5 inches. The reason for going in for surgery now is to eliminate the chances of getting malignancy in future. There is no urgency for surgery, it can be planned for in the near future. This surgery does not prevent one from developing lipomas in other areas of the body. If the lipoma is removed in toto (with its capsule), lipoma does not develop at the same site. Usually, this surgery has no risk. The size of the tumour is big and thus general anaesthesia is preferred but you can discuss with an anaesthetist regarding other forms of anaesthesia.