WHAT ARE THE RISKS OF LIPOMA REMOVAL?

Lipoma removals are generally safe and very low-risk procedures. One reason for this is that, from my experience:
1. I perform all lipoma surgeries microsurgically and endoscopically (using an operating loupe and an operating headlamp). This allows for a much more precise surgical approach with significantly smaller incisions than the size of the tumor would suggest. Tissue structures, such as nerves and blood vessels, can be much more securely located and protected during surgery. A very, very precise, albeit time-consuming, hemostasis enables me to operate "according to the anatomy book." That means I want and can see, identify, expose, and protect my anatomical structures (muscles, tendons, nerves, blood vessels, lymphatic vessels) "as in the anatomy book" during surgery. This pays off in the surgical results but unfortunately is not always well-reimbursed (by all types of health insurance providers).

2. I place great emphasis on optimized postoperative treatment and follow-up care. It is quite common for patients (even medical patients) to make unintended mistakes, firmly believing they have "done everything right." During follow-up treatments, as the treating physician, I have the opportunity to identify, explain, and correct any potential errors. This allows for the best possible outcomes, as I have been intensely involved in optimizing (surgical) scars for decades.

Despite these two points mentioned above, lipoma removal often challenges the surgeon to the maximum. I have become well acquainted with this, and therefore, I approach every lipoma operation with appropriate respect and caution. And that is precisely why our actual (individual) complication rate is close to zero:

1. Incomplete removal of a lipoma with recurrence (reappearance of the lipoma at the same location), for example, due to insufficient and time-saving preparation of the lipoma capsule and leaving lipoma remnants or not identifying satellite lipomas.

2. Overlooking and leaving smaller lipomas (so-called "satellite lipomas") in the vicinity of the removed lipoma. This can falsely indicate a recurrent lipoma.

OP-PHOTOS
Would you like to see them?

Why do we show you surgical photos?
Many people believe that surgeries are robust, blood-rich, and chaotic.
Not with us!
We operate delicately, gently, with very little blood, and with the best possible overview,
displaying all anatomical structures optimally.
We want to showcase this.
This is our surgical quality.
And this is also the reason why we have an almost "zero" complication rate in surgeries.
We aim to provide the best possible transparency for visitors to our website.
Decide for yourself, whether you would like to see these surgical photos / films.
Go to the surgical photos!

3. Nerve injury. It is quite common for lipomas to grow directly on top of nerve pathways, sometimes even being connected to them with connective tissue or displacing them. This occurs especially in the area of the extremities. Particularly sensitive nerve bundles run in the deep subcutaneous fat tissue, and their injury could result in sensory deficits in the periphery, for example, in the hand area. Rough surgical procedures during tumor removal could cause such injuries. That is precisely why I approach lipoma surgeries microsurgically without exception, especially for lipoma removals in the face.
Deeper-seated lipomas (e.g., intramuscular lipomas) could potentially result in motor nerve injuries during removal, leading to corresponding peripheral paralysis. However, I have also experienced the opposite scenario: A large lipoma in the neck was compressing the brachial plexus, causing progressive weakness and paralysis in the right arm. The patient initially sought treatment at a university clinic, where they suggested surgery on the cervical spine disc. He refused this and came to us, where I removed the large lipoma, and the arm (with its compressed nerves) recovered again.
Example Upper arm lipomas

OP-PHOTOS
Would you like to see them?

Why do we show you surgical photos?
Many people believe that surgeries are robust, blood-rich, and chaotic.
Not with us!
We operate delicately, gently, with very little blood, and with the best possible overview,
displaying all anatomical structures optimally.
We want to showcase this.
This is our surgical quality.
And this is also the reason why we have an almost "zero" complication rate in surgeries.
We aim to provide the best possible transparency for visitors to our website.
Decide for yourself, whether you would like to see these surgical photos / films.
Go to the surgical photos!

4. Blood vessel injury. Lipomas tend to grow into weak spots of nerve and blood vessel pathways under their growth pressure (as mentioned above), which should be completely removed. If the intraoperative view is not sufficient, or if there is excessive bleeding or the surgical approach is too aggressive, there is a risk of injuring such blood vessels, potentially leading to circulatory disorders in the extremity. However, in my patient population, I have not experienced a single case of this. What has happened though is that larger main veins that extend directly into the lipoma or are surrounded by it (e.g., the cephalic vein in the upper arm) are present. In these cases, there is no other choice but to sacrifice this vein, knowing that there are usually enough alternative and large-caliber veins that can take over this function. However, it is possible that initially, during the postoperative transitional period, there may be some persistent swelling of the extremity.

OP-PHOTOS
Would you like to see them?

Why do we show you surgical photos?
Many people believe that surgeries are robust, blood-rich, and chaotic.
Not with us!
We operate delicately, gently, with very little blood, and with the best possible overview,
displaying all anatomical structures optimally.
We want to showcase this.
This is our surgical quality.
And this is also the reason why we have an almost "zero" complication rate in surgeries.
We aim to provide the best possible transparency for visitors to our website.
Decide for yourself, whether you would like to see these surgical photos / films.
Go to the surgical photos!

5. Lymphatic vessel injury. I do not know of any surgeon, including plastic surgeons, who consciously expose, prepare, relocate, and preserve lymphatic vessels during lipoma removals. And therefore, no health insurance covers this either. Nevertheless, I do it because I have often seen that even larger lymphatic vessels run directly above the lipoma, for example, on the arm. Lymphatic vessels transport tissue fluid (lymph) from the periphery toward the heart. Injuring such a vessel means reduced fluid transport, leading to greater swelling of the operated extremity. I prefer preservation, resulting in much less postoperative swelling.

OP-PHOTOS
Would you like to see them?

Why do we show you surgical photos?
Many people believe that surgeries are robust, blood-rich, and chaotic.
Not with us!
We operate delicately, gently, with very little blood, and with the best possible overview,
displaying all anatomical structures optimally.
We want to showcase this.
This is our surgical quality.
And this is also the reason why we have an almost "zero" complication rate in surgeries.
We aim to provide the best possible transparency for visitors to our website.
Decide for yourself, whether you would like to see these surgical photos / films.
Go to the surgical photos!

6. Skin circulation disorders. Sometimes (very rarely), even my professional experience reaches its limits. Lipomas are true artists when it comes to creativity. For example, they can grow directly into the skin and are then no longer surgically separable. If the surgical incision is in a different location than the site of skin infiltration, it may be necessary to leave this area temporarily and remove it at a later time (e.g., after a year) in a safe follow-up procedure to avoid jeopardizing the skin's blood supply. This also applies to large lipomas that grow very close to the dermis (the corium) and, therefore, can endanger the circulation of this skin during lipoma removal. There is a risk of localized skin necrosis (necrosis) in the critical area. Surgical experience must help in this situation, both intraoperatively and postoperatively within an optimized follow-up treatment. However, this can be managed.
Example shoulder lipoma

7. Dimpling of the skin surface. As mentioned above, lipomas grow by displacement. If they are removed without the surgeon compensating for the displacement tissue defect through, sometimes somewhat elaborate, intraoperative tissue relocation into the defect area, a depression of the skin surface remains, which, based on previous experience, does not resolve even after years. This is not dangerous but can be aesthetically very disturbing. A qualified follow-up operation can correct such a problem. However, it is obviously better to do this during the initial surgery.
This category also includes cases where patients do not precisely adhere to the recommended immobilization postoperatively, in the case of intraoperative tissue relocation of fat flap plasty, and when these "soft," non-resistance fat flap plasty is torn out due to premature strain (e.g., due to improper arm movement). I have experienced this once, in the back area. Unfortunately.
Lipoma removal with dimpling

OP-PHOTOS
Would you like to see them?

Why do we show you surgical photos?
Many people believe that surgeries are robust, blood-rich, and chaotic.
Not with us!
We operate delicately, gently, with very little blood, and with the best possible overview,
displaying all anatomical structures optimally.
We want to showcase this.
This is our surgical quality.
And this is also the reason why we have an almost "zero" complication rate in surgeries.
We aim to provide the best possible transparency for visitors to our website.
Decide for yourself, whether you would like to see these surgical photos / films.
Go to the surgical photos!