Lipomatosis: what it is, causes, symptoms and treatment

• Lipomatosis is an accumulation of single lipomas in a specific area of the body.
• The duration of surgery for lipomatosis is considerably longer than for single lipomas, as several lipomas must be removed.
• In the case of a large number of lipomatosis, several operations will be necessary.

First of all, it is important to point out that we use the term lipomatosis when we refer to the appearance of numerous lipomas in one area of the body, which are usually grouped together, although they can also be scattered in one area of the body, such as the back or the abdomen.

Having clarified what lipomatosis is, a lipoma is a lump of fat (adipose tissue), unlike cysts, which are epithelial tissue that forms under the skin. 

They are called benign tumours, as they are an accumulation of non-cancerous tissue, and are usually soft to the touch, appearing mainly on the back, shoulders, neck or abdominal area. Another interesting feature is that as they are located on a fairly superficial level of the skin, their mobility can be felt when touched.

Although they are usually superficial, in some cases they occur in deeper layers of the skin, requiring slightly more complex removal surgery.

With regard to the age at which they usually appear, although it is possible for them to appear in young people, between 20 and 25 years of age for example, they usually appear in people between 40 and 60 years of age, and are very rare in children. 

Once lipomas have appeared, it is likely that there will be a predisposition and they will increase in number and size.

The exact causes of the onset of lipomatosis cannot be verbalised in a fixed way, but what can be done is to indicate some of the factors that have been found to be conducive to its occurrence:

• Genetic inheritance: In the case of isolated lipomas, there does not necessarily have to be a genetic component as any of us can develop them. On the other hand, in the case of lipomatosis (accumulation of numerous lipomas in one area of the body) there is a hereditary tendency of direct relatives, which is called multiple familial lipomatosis.
• Overweight: As these lumps are made up of adipose tissue, fat, an increase in the patient's weight related to the increase in fat may favour it, although this is not conclusive.
• Gender: The occurrence of isolated lipomas is higher in women, as they are more prone to fat accumulation in various parts of the body, but not in the case of lipomatosis, which is much more common in men than in women.
• Alcohol consumption: Drinking alcohol on a regular basis may also increase the risk of developing lipomatosis.
• Medical conditions: Liver disease or having difficulty controlling blood sugar can increase the risk of lipomas.

Although lipomatosis or isolated lipomas are not usually a serious health problem, in some cases it may be related to other medical problems, such as the liver problems mentioned above, which although not common, it is important to see a specialist in general surgery for assessment.

Although lipomas are aetiologically the same, accumulation of fatty tissue, in the case of lipomatosis, can be differentiated according to the area where they are found. 

These include congenital infiltrative lipomatosis of the face, pelvic lipomatosis, encephalocutaneous lipomatosis, painful lipomatosis and neural lipomatosis.

Beyond this normal lipomatosis, we can include two more types of lipomatosis, although one of them is a derivation of the normal lipomatosis:

• Painful adiposis: This is a derivation of lipomatosis and is more common in postmenopausal and overweight women, and can cause swelling of the area and chronic fatigue.
• Multiple symmetrical lipomatosis: Unlike the previous one, this type of lipomatosis occurs mainly in middle-aged men, especially in those who have abused alcohol for a long time. These lipomas form mainly in the area of the clavicle, nape of the neck, neck and extremities.

Lipomatosis does not usually cause symptoms beyond the appearance of the lumps that are essentially lipomas.

The main difference between simple lipoma and lipomatosis is that lipomatosis is a large number of lipomas in a specific area.

Pain is a very rare symptom but pain and swelling may occur, especially in the case of lipomas caused by microtrauma.

On the other hand, infection of lipomas, both simple and in lipomatosis, can occur, causing enlargement and reddening of the skin, which should be treated with antibiotics to control the infection before lipoma removal surgery is carried out.

The best way to find out is to be told by a specialist in a face-to-face consultation. 

Although it can be seen with the naked eye, as there are usually several lipomas in one area, tissue analysis may be needed to see if the fat cells are encapsulated or not, allowing the doctor to determine if they are normal lipomas or if they are, for example, multiple symmetrical lipomatosis.

It is also possible that if the lipoma is very deep, the specialist may require an ultrasound scan to determine the depth of the lipoma and thus be able to focus the surgery more safely and efficiently. In these cases, the removal procedure is usually more complex and longer-lasting than for simple lipomas.

The only definitive treatment for lipomatosis is surgical removal of the capsule that forms the lipoma. This is a very common surgery, mainly for cosmetic reasons, and is not usually very delicate unless the lipoma is in very deep layers of the skin.

It must be taken into account that in the case of lipomatosis, depending on the number of lipomas, several interventions may be required, as it is not always possible to remove them all at the same time, this being the only difference with respect to other simple lipoma surgeries.

In any case, the procedure to follow when it comes to solving lipomatosis is the same:

1. Once the patient has decided, together with the specialist, that he/she wants to undergo surgery, he/she goes to the medical centre on the day set for the surgery.
2. There they hand in all the documentation that is indicated in admission and then they will be taken to the operating theatre.
3. It is an outpatient surgery (you go home after the operation) so you do not need a room.
4. In the operating theatre, you will meet the surgeon and a member of the nursing staff who will assist in the process.
5. The surgeon will first apply a local anaesthetic around the area of the lipoma to be removed.
6. The surgeon then makes an incision in the skin and removes the different layers until the lipoma is reached. Once there, the surgeon removes the entire capsule, eliminating it completely.
7. Finally, the surgeon sutures the incision layer by layer.
8. In the case of lipomatosis, the process is repeated several times.

Surgery for a simple lipoma usually lasts between 30 and 40 minutes, although in the case of lipomatosis this is longer because it is performed several times, so it is possible that the operation will have to be performed several times.

After surgery, the doctor will give you some recommendations for the care of the surgical wound.

If you are considering treating your lipomatosis problem, you can request an immediate and free surgical assessment consultation below: