Q: Dr. Eppley, I’ve read the section with patient questions about lipomas and I have a similar case. I had surgery 3 years ago that removed the biggest lipomas from my body but I still have multiple smaller ones all over my arms, upper legs and back. Maybe 20 on my arms, 20 to 30 on my legs and 3 to 4 on my back ( half of them are the size of a walnut). I’ve read that a combination of injections and laser treatment would be the best approach in my case . I completely understand that it would be just an estimate (and multiple treatments might be required) but I would like to know at least what would be the general range. I would appreciate your help in this matter.
A: While lipomas can be treated effectively by lipodissolve injection therapy and Smartlipo laser probe ablation, this approach is best used for a limited number of lipomas. This is because each lipoma so injected is associated with a significant inflammatory response (and pain) and will definitely require multiple treatments. When the lipomas number more than a handful, one is better off having an outpatient procedure where they are completely excised as this is simply more efficient and cost-effective….not to mention has less discomfort and an easier recovery compared to a multi-stage non-excisional approach. I would only consider an injection approach in a limited number of them to bother determine their response and a patient’s tolerance for it.
Dr. Barry Eppley
Q: Hi, I wanted to ask you about lipolysis injection treatment in lipomas. I want to ask whether the method of lipolysis is effective over the lipoma. How many sessions are needed? Will I have the desired effect? I want your opinion on this matter… thank you.
A: There is no doubt that the excision of lipomas is standard treeatment because it is more effective and a one-time surgery for that specific lipoma. While there is a trade-off of a scar, it usually is less in size than that of the diameter of the lipoma. But for those who are opposed to excision, injection therapy can be done. But it will take multiple sessions whose number depends on how big the lipoma is. For each cm in lipoma size, there is usually 2 injection sessions. So measure yours and you can do the math to see how many injections sessions might be needed. There is also a higher risk of recurrence with injection therapy because not all of the lipoma, or its attached blood supply, may be completely eradicated.