Subcutaneous lipoma
The conventional type, and by far the most common. Sits directly under the skin, moves freely, and comes out through a small incision under local anesthetic.
Lipoma Removal · Los Angeles
Lipoma removal by surgical oncologists
Complete excision through the smallest practical incision, closed in layers, with pathology on every specimen. Performed by Dr. Jason Cohen and Dr. Joshua Ellenhorn.
- 36,782 Successful surgeries performed
- 126 Years of combined experience
- 2 Board-certified surgical oncologists
The basics
What is a lipoma?
A lipoma is a benign growth of mature fat cells that develops in the soft tissue just beneath the skin. It is contained within a thin fibrous capsule, which is what allows it to slide freely when you press on it, and what makes complete removal possible in one piece.
Lipomas are the most common soft tissue growth in adults. They typically appear between the ages of 40 and 60, affect men and women about equally, and most commonly show up on the neck, shoulders, back, upper arms, buttocks and thighs.
Left alone, a typical lipoma grows very slowly and then stops. It does not spread, it does not invade surrounding tissue, and it does not become cancerous.
- Soft, doughy and freely movable under the skin
- Slow growing, usually between 1 and 3 cm at diagnosis
- Painless in most cases, unless it presses on a nerve
- Round or oval, with clearly defined edges
Variants
Types of lipomas we treat
Most lipomas are conventional and straightforward. Several variants behave differently enough to change the surgical plan, which is worth knowing before you book.
Angiolipoma
Contains extra blood vessels alongside the fat, which makes it genuinely tender. Often appears as several small lumps on the forearms in younger adults.
Fibrolipoma
Fat mixed with fibrous connective tissue, so it feels firmer than a conventional lipoma and can be mistaken for something more concerning on examination.
Intramuscular lipoma
Grows within or beneath muscle rather than under the skin. Harder to feel, harder to remove, and the variant most often referred to us by other surgeons.
Spindle cell and pleomorphic
Uncommon variants with cell features that overlap with liposarcoma under the microscope. Complete excision and expert pathology matter most here.
Familial multiple lipomatosis
An inherited pattern producing many lipomas, usually on the arms and trunk, from early adulthood onward. We prioritise the ones causing symptoms.
Ruling out the serious version
Liposarcoma: rare, but the reason we never assume
Liposarcoma is a malignant tumor of fat tissue. It is uncommon, but it can present as a painless lump in exactly the places a lipoma appears, and on examination alone the two are not always separable.
This is the practical difference between a general clinic and a surgical oncology practice. We plan the operation around the possibility that a mass is not what it appears to be, and we confirm with pathology every single time rather than relying on how it looked in the room.
Signs a fatty mass needs prompt assessment
Larger than 5 cm. Noticeable growth over weeks rather than years. Firm rather than soft. Fixed in place instead of mobile. Located deep in muscle or the abdomen. Painful without an obvious cause.
Diagnosis
How a lipoma is diagnosed
Most lipomas are confidently identified in the room. Imaging is added when the mass is large, deep, fixed or changing.
Physical examination
Size, depth, mobility and tenderness. A soft, mobile, slow growing lump with clear edges is almost always a lipoma, and often needs nothing further.
Ultrasound
Quick, no radiation, and good at confirming a mass is fatty and superficial. Usually the first imaging step when one is warranted.
MRI or CT
Reserved for masses that are large, deep, or near nerves and vessels. MRI shows the exact plane a lipoma occupies and what sits next to it.
Pathology
The definitive answer. Every specimen we remove is examined by a pathologist, so the diagnosis is confirmed rather than presumed.
Choosing an approach
Surgical excision compared with liposuction
Both remove a lipoma. Only one removes the capsule and gives you a specimen to test, which is why excision is what we recommend in nearly every case.
| Comparison point | Surgical excision | Liposuction |
|---|---|---|
| How it works | A small incision over the mass, then the lipoma and its capsule are lifted out intact. | A cannula is inserted through a tiny opening and the fatty contents are suctioned out. |
| Best suited to | Almost all lipomas, and essential whenever the diagnosis is not certain. | Large, soft, clearly benign lipomas in areas where scar length matters a great deal. |
| Recurrence risk | Low. The capsule is what regrows, and it is removed. | Higher. The capsule is left behind, so the lipoma can refill over time. |
| Specimen for pathology | Yes. The whole mass goes to pathology and the diagnosis is confirmed. | Limited. Suctioned fragments make a definitive diagnosis much harder. |
| Scar | A fine line, usually shorter than the lipoma is wide, placed in a natural skin crease. | Smaller entry point, but contour irregularity is possible if debulking is uneven. |
| Anesthetic | Local for most lipomas. General only for deep or very large masses. | Local or sedation depending on size and site. |
Steroid injection is sometimes offered as a non-surgical option. It can shrink a lipoma modestly, rarely removes it, and leaves the capsule in place, so we do not recommend it as a definitive treatment.
Cosmetic result
How we keep the scar small
A lipoma removal is a minor operation with a permanent cosmetic result. These four things account for most of the difference in how a scar ends up looking.
Incisions along skin lines
Placed to follow the natural tension lines of the skin, and hidden in a crease or hairline where the anatomy allows.
The smallest workable opening
A capsule can often be delivered through an incision shorter than the mass is wide, so the scar is shorter than patients expect.
Tension-free layered closure
Deep layers take the load so the skin edges simply meet. Tension across a closure is the main cause of a wide, raised scar.
Scar aftercare
Specific guidance on taping, silicone and sun protection for the first months, which is when a scar is still actively maturing.
Afterwards
Recovery after lipoma surgery
For a typical subcutaneous lipoma, recovery is genuinely straightforward. You walk out the same day, discomfort is mild and handled with over the counter pain relief, and most people are back to desk work and normal routine the next day.
You will leave with written instructions covering the dressing, when you can shower, what to watch for, and when to come back. Deeper or larger excisions take longer, and we give you a specific timeline rather than a general one.
- Back to light routine and desk work the next day for most patients
- Keep the incision clean and dry for the period we specify
- No heavy lifting, swimming or hard training for around two weeks
- A short follow-up to check healing and go through your pathology result
Call us straight away if
you develop spreading redness, increasing pain after the first few days, drainage from the wound, or a fever. These are uncommon and easy to deal with early.
Your surgeons
Who performs your procedure
Both of our surgeons are board-certified and fellowship-trained in surgical oncology, which is the subspecialty that deals with soft tissue tumors of exactly this kind.
Dr. Jason Cohen, MD, FACS
Surgical Oncologist
Board-certified surgical oncologist known for removing large and difficult lipomas with minimal scarring. Featured on the TLC series Take My Tumor.
- Lipoma and soft tissue tumor removal
- Liposarcoma diagnosis and surgery
- Minimal-scar excision technique
25 years in practice
Full profile
Dr. Joshua Ellenhorn, MD, FACS
Surgical Oncologist
Board-certified surgical oncologist specialising in soft tissue tumors, including the atypical fatty masses that need ruling out for liposarcoma.
- Soft tissue tumor surgery
- Liposarcoma and sarcoma care
- Complex and deep lipoma excision
30 years in practice
Full profile
No obligation
Not sure whether yours needs removing?
Send a photo and a short description. We will give you a straight answer, including if the answer is to leave it alone.
Common questions
Lipoma removal questions
Does lipoma removal hurt?
The injection of local anesthetic stings briefly. After that you should feel pressure and movement but not pain. Most patients are surprised how little there is to it. Afterwards there is mild soreness for a few days, usually managed with paracetamol or ibuprofen.
How long does the procedure take?
A straightforward subcutaneous lipoma takes roughly 30 to 60 minutes from the first injection to the last stitch. Larger or deeper masses, particularly intramuscular ones, take longer and are planned accordingly.
Will my insurance cover it?
Often yes, when the lipoma is symptomatic: painful, growing, interfering with function, or clinically uncertain enough to require removal. Removal purely for appearance is usually treated as cosmetic. Our office will check your specific plan and tell you what to expect before you commit.
Can you remove more than one in the same visit?
Frequently, yes. Several small lipomas in the same region are often dealt with in one sitting. It depends on how many there are, how large, and how spread out. We work that out at the consultation and prioritise the ones causing symptoms.
Do I need to stop any medications beforehand?
Possibly. Blood thinners and some supplements increase bleeding and bruising, so bring a complete list of everything you take, including over the counter products, to your consultation. We will tell you exactly what to pause and for how long. Never stop a prescribed medication without being told to.
When will I get my pathology result?
Typically within about a week. We contact you with the result either way, and we go through what it means at your follow-up. You will not be left wondering.
Schedule a Consultation
Book your lipoma consultation
Tell us where the lump is, how long it has been there, and whether it has changed. One of our surgeons reviews every enquiry personally.
- Reviewed by a board-certified surgical oncologist
- Same-week appointments in Los Angeles
- Most removals done in a single visit under local anesthetic
- Pathology on every specimen, so you get a definitive answer
- Call the office (310) 289-1518
- Visit us 8635 W 3rd St #880 W, Los Angeles, CA 90048 (opens a map in a new tab)
Request your consultation
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