A lipoma is a benign (non-cancerous) growth of fatty tissue that forms a soft, rubbery lump beneath the skin. These tumors are composed of adipose (fat) cells and usually grow slowly over time. While lipomas are generally harmless and painless, some people may choose to remove them for cosmetic reasons or if they cause discomfort due to size or location.

Lipomas are among the most common soft tissue tumors and can occur in people of all ages, although they are most frequently diagnosed in adults between the ages of 40 and 60. Most lipomas do not require treatment unless they interfere with daily life or become painful.

Common Locations

Lipomas can develop almost anywhere on the body but are most commonly found in areas with high fat concentration, such as:

  • Neck

  • Shoulders

  • Back

  • Arms

  • Thighs

  • Abdomen

They typically sit just beneath the skin (subcutaneous) but may also form deeper within muscles or organs in rare cases.

Signs and Symptoms

Lipomas are usually easy to identify based on their appearance and feel. Common signs and symptoms include:

  • Soft, doughy, and movable lumps under the skin

  • Usually painless, although pain can occur if the lipoma presses on nearby nerves

  • Typically less than 2 inches in diameter but can grow larger

  • Slow-growing over months or years

  • Skin over the lump remains normal in color and texture

If a lump is hard, painful, grows quickly, or changes in shape, it may not be a lipoma and should be examined by a healthcare provider.

Types of Lipomas

While all lipomas are composed of fat, there are different types based on their cellular structure:

  • Conventional lipoma: Most common type, made of mature fat cells

  • Fibrolipoma: Contains fibrous tissue in addition to fat

  • Angiolipoma: Contains blood vessels and may be painful

  • Myelolipoma: Contains fat and blood-forming tissues, usually found in adrenal glands

  • Spindle cell lipoma: Contains fat and spindle-shaped cells

  • Pleomorphic lipoma: Contains a variety of fat cells of different shapes and sizes

Causes and Risk Factors

The exact cause of lipomas is not fully understood, but several factors may increase the likelihood of developing them:

  • Genetics: Lipomas often run in families and may be linked to inherited conditions

  • Age: Most common in middle-aged adults

  • Injuries: Some lipomas may appear after trauma to soft tissue, though this connection is not fully confirmed

  • Certain conditions: Conditions such as familial multiple lipomatosis, Gardner's syndrome, and Madelung's disease are associated with multiple lipomas

Diagnosis

Diagnosing a lipoma typically involves a physical exam. In some cases, your healthcare provider may order imaging tests or a biopsy to confirm the diagnosis:

  • Physical exam: Palpation of the lump to assess texture, size, and mobility

  • Ultrasound: Helps distinguish a lipoma from cysts or other soft tissue masses

  • MRI or CT scan: Used for deep or large lipomas

  • Biopsy: A small sample of tissue is examined under a microscope to rule out liposarcoma (a rare cancerous tumor)

Treatment Options

Most lipomas do not require treatment unless they cause symptoms or cosmetic concern. Common treatment options include:

  • Observation: Regular monitoring for changes in size or symptoms

  • Surgical removal: The most effective treatment, especially for large, painful, or bothersome lipomas

  • Liposuction: Fat is suctioned out using a needle; may not remove the entire lipoma

Surgery is generally safe and effective with minimal scarring. Lipomas rarely recur after complete removal.

Complications

Although lipomas are benign, complications can arise in some cases:

  • Pain due to pressure on nerves or nearby structures

  • Infection or bleeding (rare)

  • Recurrence after removal (uncommon)

  • Psychological discomfort or self-consciousness due to appearance

It is important to differentiate lipomas from other more serious conditions. Liposarcomas, although rare, may resemble lipomas and require prompt medical treatment.

When to See a Doctor

You should consult a healthcare provider if you notice any of the following:

  • A lump that grows rapidly

  • A hard or immobile lump

  • Painful or tender mass

  • Skin changes over the lump

  • Uncertainty about the nature of the lump

Prompt evaluation can rule out more serious conditions and provide peace of mind.

Living With Lipomas

Most people with lipomas lead normal lives without any health complications. However, for those with multiple or recurring lipomas, regular monitoring and communication with a healthcare provider are important.

Self-care tips:

  • Monitor for size and symptom changes

  • Avoid trauma to areas with lipomas

  • Keep medical records and photos for tracking

Support groups or counseling may be beneficial for individuals affected emotionally or socially by visible lipomas.