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A lipoma is a benign tumor made up of adipose cells (adipocytes or fat cells). As a benign tumor its growth is strictly local, it never metastasizes.

In its typical form of subcutaneous lipoma, it takes the form of a ball, visible under the skin, firm, mobile, non-adherent, more or less large, sometimes painful. Its placement can be anywhere.

No cause has been found to date. A family origin is implicated in some cases. Cases of lipomatosis (multiple lipomas) have been described. Lipoma growth is very slow (several years).

Video treatment of a fatty lipoma by Dr. Masson in Paris

The only treatment is surgical: incision and direct removal of the lipoma. Liposuction makes it possible to reduce the size of the scar but is not a good solution: it renders it impossible to analyze what has been removed (multiple cellular debris) and, above all, there is an almost systematic recurrence of the lesion (because everything is never removed, in particular the membrane around the lipoma).

A lipoma is removed if it is aesthetically annoying (for example in the middle of the forehead), if it hurts, if it is badly located (near a large vessel or a nerve), if it risks growing to compress a noble structure (nerve, vein, artery …) or if it is suspected to be not a lipoma but another potentially serious lesion (a very painful, red, inflammatory lipoma, which enlarges very quickly in size).

An ultrasound is often performed before the procedure to verify that the lipoma is very superficial, that it does not begin in the underlying muscle and that it is not hypervascularized. Surgery is performed with or without hospitalization, under general or local anesthesia, depending on the location and size of the lesion. The scar is most often discreet and placed in a strategic location so as to not be too visible (for example, for a frontal lipoma, the scar is ideally placed close to the hair). The post-operative effects are most often straightforward.

A histological examination is carried out systematically.

The main complications are hematoma, scarring difficulties and recurrence.

The procedure is carried out by a dermatologist for the smallest and easily accessible lesions, by a visceral surgeon, orthopedist or general surgeon for medical indications or by a cosmetic surgeon like Dr. Masson if the indication for excision of the lipoma is more aesthetic than medical (e.g., an unattractive lipoma of the face, an area exposed to the regards of other people, a desire to have as fine a scar as possible, laser suturing technique, etc.).

It is worth knowing that if the procedure is indicated for aesthetic reasons, the French health insurance system will reimburse it very badly, if at all. The same applies for top-up or complementary health insurance companies. The fees depend on the anatomical area or region, the operating technique, the size of the lesion, whether or not it is encapsulated, the anesthesia procedures and the number of lesions.

The usual fees for a cosmetic surgeon like Dr. Masson are generally from 700 to 3000 euros.

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Dr Vincent Masson is a plastic surgeon with a post-graduate diploma in plastic, reconstructive and aesthetic surgery and a gold medal in surgery from the Paris Hospitals. He is a former senior registrar and attaché at the Hôpital Saint Louis.

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